Individual
FABIOLA ELIZABETH DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4515 E 91ST ST STE 201, TULSA, OK 74137-2862
(918) 730-9123
Mailing address
624 E ROBBERTS AVE, KINGFISHER, OK 73750-2838
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
05/24/2024
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