Individual
MEGAN ASHLEY FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 S MAIN ST, STILLWATER, OK 74074-5846
(405) 564-3408
Mailing address
7800 W 63RD PL N, TULSA, OK 74126-4240
(918) 946-8231
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB691661
OK
Other
Enumeration date
07/01/2021
Last updated
07/01/2021
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