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General NPI Number Information
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NPI Number | 1093210098
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Entity Type | Individual
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Provider Name | TAMARA DORSEY WHITEMAN BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 1505 W GORE BLVD
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City | LAWTON
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State | OK
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Zip | 73501-3608
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Country | US
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Telephone | 580-699-2700
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Fax | 303-322-9001
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Provider Business Mailing Address
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Address Line | 502 NW FORT SILL BLVD
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City | LAWTON
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State | OK
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Zip | 73507-6604
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Country | US
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Telephone | 703-638-0329
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Fax | 817-382-2934
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-18-29874
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License Number State |
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