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NPI Code Detail

MEDICARE: ALLEY PAIGE MECHELLE FERGUSON

MEDICARE:   ALLEY PAIGE MECHELLE FERGUSON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1841980547
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLEY PAIGE MECHELLE FERGUSON
Provider Business Mailing Address
First Line : 3015 E SKELLY DR STE 395
Second Line :
City : TULSA
State : OK
Zip : 74105-6348
Country : US
Telephone Number : 918-764-8378
Fax Number :
Provider Business Practice Location Address
First Line : 3015 E SKELLY DR STE 395
Second Line :
City : TULSA
State : OK
Zip : 74105-6348
Country : US
Telephone Number : 918-764-8378
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2023
Last Update Date : 05/08/2023

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Directions to “ ALLEY PAIGE MECHELLE FERGUSON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.