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NPI Code Detail

MEDICARE: KRISTINA A MEALY BCBA

MEDICARE: KRISTINA A MEALY 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
1103K00000XBehavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst1-24-74901OK

General Provider Information

NPI Number : 1427611433
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA A MEALY BCBA
Provider Business Mailing Address
First Line : 2474 E JOYCE BLVD STE 2
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4932
Country : US
Telephone Number : 479-521-8326
Fax Number : 479-521-5439
Provider Business Practice Location Address
First Line : 11412 N 134TH EAST AVE STE C3
Second Line :
City : OWASSO
State : OK
Zip : 74055-4969
Country : US
Telephone Number : 855-782-7822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2019
Last Update Date : 10/22/2024

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Directions to “ KRISTINA A MEALY BCBA” Practice Location

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