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General NPI Number Information
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NPI Number | 1215469812
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Entity Type | Individual
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Provider Name | ALISHA MARIE CORZINE-MYERS BCBA
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Gender | Female
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Dates
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Enumeration Date | 04/01/2017
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 11424 FAIRWAYS AVE 11424 FAIRWAYS AVE
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City | YUKON
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State | OK
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Zip | 73099-9760
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Country | US
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Telephone | 720-937-6692
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Fax |
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Provider Business Mailing Address
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Address Line | 11424 FAIRWAYS AVE
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City | YUKON
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State | OK
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Zip | 73099-9760
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Country | US
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Telephone | 720-937-6692
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Fax |
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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 | 1-18-32886
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-17-7726
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-18-32886
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License Number State | OK
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