Individual
BREHAUNA B BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1018 24TH AVE NW STE 110, NORMAN, OK 73069-6556
(405) 310-5306
Mailing address
PO BOX 406, NOBLE, OK 73068-0406
(405) 414-7721
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-146932
OK
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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