Provider Demographics
NPI:1285070300
Name:MEREDITH ANN ALBIN RN, BCABA, PLLC
Entity type:Organization
Organization Name:MEREDITH ANN ALBIN RN, BCABA, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ALBIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BCABA
Authorized Official - Phone:580-786-4538
Mailing Address - Street 1:1509 BROOKWOOD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1316
Mailing Address - Country:US
Mailing Address - Phone:580-786-4538
Mailing Address - Fax:580-606-6642
Practice Address - Street 1:1509 BROOKWOOD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1316
Practice Address - Country:US
Practice Address - Phone:580-786-4538
Practice Address - Fax:580-606-6642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0-11-4294103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty