MEDICARE: APRIL FIELDS

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	L082147621	OK

General Provider Information

NPI Number	:	1659790699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APRIL FIELDS

Provider Business Mailing Address
First Line	:	3208 SW 82ND ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-4425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3208 SW 82ND ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-4425
Country	:	US
Telephone Number	:	405-613-9580
Fax Number	:

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

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	04/07/2014

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Directions to “ APRIL FIELDS ” Practice Location

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