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General NPI Number Information
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NPI Number | 1942885876
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Entity Type | Organization
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Legal Business Name | MOMENTUM LEARNING LLC
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 3015 E SKELLY DR STE 390
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City | TULSA
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State | OK
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Zip | 74105-6362
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Country | US
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Telephone | 808-226-8487
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Fax |
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Provider Business Mailing Address
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Address Line | 3015 E SKELLY DR STE 395
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City | TULSA
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State | OK
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Zip | 74105-6317
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Country | US
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Telephone | 918-764-8378
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/CEO
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Name | JESSICA COLLINS
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Credential | M.S., BCBA, LBA
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Telephone | 918-764-8378
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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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