Healthcare Provider Details

I. General information

NPI: 1013756188
Provider Name (Legal Business Name): SUNFLOWER BEHAVIOR THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 W MEMORIAL RD APT 15G
OKLAHOMA CITY OK
73142-2042
US

IV. Provider business mailing address

5300 W MEMORIAL RD APT 15G
OKLAHOMA CITY OK
73142-2042
US

V. Phone/Fax

Practice location:
  • Phone: 620-870-9700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: DARCI DAVIS
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential:
Phone: 620-870-9700