Individual
DEADRA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13913 S WESTERN AVE, OKLAHOMA CITY, OK 73170-7011
(405) 445-5567
Mailing address
8300 NW 10TH ST OFC 152, OKLAHOMA CITY, OK 73127-2959
(405) 898-5214
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-412569
OK
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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