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NPI Code Detail

MEDICARE: SARAH MICHELLE COUCH

MEDICARE: SARAH MICHELLE COUCH
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 : 1871106252
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH MICHELLE COUCH
Provider Business Mailing Address
First Line : 2208 W DETROIT ST
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-3629
Country : US
Telephone Number : 918-900-6237
Fax Number : 918-561-6764
Provider Business Practice Location Address
First Line : 2208 W DETROIT ST
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-3629
Country : US
Telephone Number : 191-890-0623
Fax Number : 918-561-6764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2020
Last Update Date : 02/13/2023

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Directions to “ SARAH MICHELLE COUCH ” Practice Location

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