Individual
MRS. ROSIE MARIE GRUBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 1 BOX 125, BOLEY, OK 74829-9724
(918) 667-3718
Mailing address
RR 1 BOX 125, BOLEY, OK 74829-9724
(918) 667-3718
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147730845
—
OK
Enumeration date
12/27/2010
Last updated
12/27/2010
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