Individual
LISA WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 NW 10TH #B, OKLAHOMA CITY, OK 73170
(913) 940-3768
Mailing address
1104 NW 10TH ST APT B, MOORE, OK 73170-1256
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
G000053186
OK
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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