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NPI Code Detail

MEDICARE: AMIKO FALLON ASAMEN

MEDICARE: AMIKO FALLON ASAMEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-25-86129OK
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1013419449
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIKO FALLON ASAMEN
Provider Business Mailing Address
First Line : RR 1 BOX 144
Second Line : 444379 E 956 ROAD
City : GORE
State : OK
Zip : 74435-9507
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4515 E 91ST ST STE 201
Second Line :
City : TULSA
State : OK
Zip : 74137-2862
Country : US
Telephone Number : 918-730-9123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2018
Last Update Date : 12/19/2025

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Directions to “ AMIKO FALLON ASAMEN ” Practice Location

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