Provider Demographics
NPI:1124796412
Name:SEXTON, SHELBY LIND (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LIND
Last Name:SEXTON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9816 S MAY AVE
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044
Mailing Address - Country:US
Mailing Address - Phone:405-285-7622
Mailing Address - Fax:405-285-7622
Practice Address - Street 1:9816 S MAY AVE
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044
Practice Address - Country:US
Practice Address - Phone:405-285-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
OK1-23-66535103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst