Individual
MOLLY WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2248 NW 164TH ST, EDMOND, OK 73013-8801
(405) 572-3776
(405) 562-3313
Mailing address
3517 NW 164TH TER, EDMOND, OK 73013-9471
(808) 343-9757
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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