Individual
MS. CAROL SUE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E 14TH ST, ADA, OK 74820-6915
(918) 426-5272
Mailing address
1301 S PARK ST TRLR A27, SAPULPA, OK 74066-5645
(918) 227-9898
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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