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NPI Code Detail

MEDICARE: MEGAN SEDLACEK RBT

MEDICARE: MEGAN SEDLACEK RBT
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
1171M00000XCase Manager/Care Coordinator
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1699241406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN SEDLACEK RBT
Provider Business Mailing Address
First Line : 4 RYAN PL
Second Line :
City : KIEFER
State : OK
Zip : 74041-4558
Country : US
Telephone Number : 918-697-9564
Fax Number :
Provider Business Practice Location Address
First Line : 3501 W KENOSHA ST
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-8948
Country : US
Telephone Number : 918-994-2764
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2018
Last Update Date : 09/29/2021

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