Individual
RUSHITA TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MTEACH, BCBA
Contact information
Practice address
1817 COMMONS CIR STE A, YUKON, OK 73099-9522
(405) 467-6782
Mailing address
1824 COMMONS CIR STE B, YUKON, OK 73099-9538
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-36123
OK
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/15/2018
Last updated
03/17/2022
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