MEDICARE: THERESA PARAMORE BCBA

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
1	103K00000X	Behavior Analyst	1-20-41986	OK
2	247200000X	Other Technician	RBT-18-59164

General Provider Information

NPI Number	:	1265998710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA PARAMORE BCBA

Provider Business Mailing Address
First Line	:	1900 E 15TH ST BLDG 900
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-6610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 E 15TH ST BLDG 900
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-6610
Country	:	US
Telephone Number	:	405-455-6868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2019
Last Update Date	:	07/10/2022

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Directions to “ THERESA PARAMORE BCBA” Practice Location

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