Most Relevant Information
Provider Data
| NPI Number: | 1003597048 |
| Provider Name: | SHANNON MAE O'MEILIA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-23-281563 |
Most Important Dates
| Enumeration Date: | 07/31/2023 |
| Last Updated: | 07/31/2023 |
Provider Practice Location
4515 E 91ST ST
TULSA
OK
741372861
Practice Location Phone/Fax
| Phone: | 8557827822 |
| Fax: |
Provider Mailing Location
4515 E 91ST ST
TULSA
OK
741372861
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |