Individual
CASEY ELIZABETH SERGOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
614 S MAIN ST, STILLWATER, OK 74074-4059
(405) 564-3408
(844) 270-2039
Mailing address
7723 E 31ST ST, TULSA, OK 74145-1246
(618) 610-6436
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-20-134512
OK
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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