Organization
STATE OF OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILFRED STEPHEN SAMPSON MS (CLINICAL BEHAVIORAL HEALTHCARE SPEC)
(918) 293-2140
Entity
Organization
Contact information
Practice address
2323 SOUTH HARVARD, TULSA, OK 74114
(918) 293-2140
(918) 912-7164
Mailing address
2323 SOUTH HARVARD, TULSA, OK 74114
(918) 293-2140
(918) 912-7164
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/07/2009
Last updated
02/01/2011
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