Individual
JORDAN TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1121 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-5210
(855) 782-7822
Mailing address
18980 SE 21ST ST, HARRAH, OK 73045-6201
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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