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General NPI Number Information
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NPI Number | 1750097572
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Entity Type | Individual
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Provider Name | SHANE ARTHUR CARMAN
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Gender | Male
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 1063 RAINTREE MANSION
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City | YUKON
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State | OK
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Zip | 73099-2111
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Country | US
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Telephone | 405-519-4047
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 RICHMOND SQ STE 110
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-2040
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Country | US
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Telephone | 580-649-4425
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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