Individual
RAVEN GRANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2210 24TH AVE NW, NORMAN, OK 73069-6496
(405) 857-8280
Mailing address
2210 24TH AVE NW, NORMAN, OK 73069-6496
(405) 857-8280
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-64491
OK
Other
Enumeration date
06/21/2022
Last updated
11/19/2025
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