Healthcare Provider Details

I. General information

NPI: 1164185609
Provider Name (Legal Business Name): ABOVE AND BEYOND ABA OK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7875 E 51ST ST
TULSA OK
74145-7847
US

IV. Provider business mailing address

9905 S PENNSYLVANIA AVE STE A
OKLAHOMA CITY OK
73159-6920
US

V. Phone/Fax

Practice location:
  • Phone: 405-649-5579
  • Fax:
Mailing address:
  • Phone: 405-649-5579
  • 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: MATT ROKOWSKY
Title or Position: MANAGER
Credential:
Phone: 732-806-0091