Individual
KENT THOMAS HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
8007 NW 122ND ST, OKLAHOMA CITY, OK 73142-3302
(405) 603-6622
Mailing address
4446 BLACKTHORN DR, EDMOND, OK 73012-0912
(405) 413-6364
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73310
OK
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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