Individual
SAMUEL R ALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 E MEMORIAL RD STE 700, OKLAHOMA CITY, OK 73114-2287
(915) 474-5087
Mailing address
14300 N MAY AVE APT 4303, OKLAHOMA CITY, OK 73134-5053
(414) 640-2401
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-442736
OK
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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