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NPI Code Detail

MEDICARE: AALIYAH WARTHEN

MEDICARE: AALIYAH WARTHEN
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 : 1942162557
Entity Type Code : Individual
Provider Name (Legal Business Name) : AALIYAH WARTHEN
Provider Business Mailing Address
First Line : 3005 SW PARK AVE
Second Line :
City : LAWTON
State : OK
Zip : 73505-7902
Country : US
Telephone Number : 580-699-5558
Fax Number : 580-699-5559
Provider Business Practice Location Address
First Line : 3005 SW PARK AVE
Second Line :
City : LAWTON
State : OK
Zip : 73505-7902
Country : US
Telephone Number : 580-699-5558
Fax Number : 580-699-5559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ AALIYAH WARTHEN ” Practice Location

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