Healthcare Provider Details

I. General information

NPI: 1215469812
Provider Name (Legal Business Name): ALISHA MARIE CORZINE-MYERS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISHA MARIE CORZINE SANDERS BCABA

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11424 FAIRWAYS AVE 11424 FAIRWAYS AVE
YUKON OK
73099-9760
US

IV. Provider business mailing address

11424 FAIRWAYS AVE
YUKON OK
73099-9760
US

V. Phone/Fax

Practice location:
  • Phone: 720-937-6692
  • Fax:
Mailing address:
  • Phone: 720-937-6692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-17-7726
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-32886
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-18-32886
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: