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General NPI Number Information
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NPI Number | 1831921303
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Entity Type | Organization
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Legal Business Name | SUGAR SWEET REHABILITATION SERVICES
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 3000 UNITED FOUNDERS BLVD STE 139P
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4361
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Country | US
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Telephone | 405-977-9671
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Fax | 405-518-8007
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Provider Business Mailing Address
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Address Line | 3000 UNITED FOUNDERS BLVD STE 139P
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4361
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Country | US
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Telephone | 405-977-9671
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUGAR GILLESPIE
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Credential | LPC
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Telephone | 405-977-9671
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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 |
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License Number State |
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