Individual
BRANDY THREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
13913 S WESTERN AVE, OKLAHOMA CITY, OK 73170-7011
(405) 445-5567
Mailing address
14037 SE 44TH ST, CHOCTAW, OK 73020-6004
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-415324
OK
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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