Individual
SHERTAURUS WARMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12317 E 18TH ST, TULSA, OK 74128-6602
(573) 462-6792
Mailing address
12317 E 18TH ST, TULSA, OK 74128-6602
(573) 462-6792
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58094
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-22-58094
BACB
MO
Enumeration date
02/19/2022
Last updated
02/07/2023
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