Individual
LEANN STORCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21450 W BENDER RD, BRAMAN, OK 74632-9278
(405) 370-4319
Mailing address
21450 W BENDER RD, BRAMAN, OK 74632-9278
(405) 370-4319
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT21152035
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT21152035
REGISTERED BEHAVIORAL THERAPIST
OK
Enumeration date
02/05/2021
Last updated
02/05/2021
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