Individual
JADEN THAI ALEXANDRIA LIEDTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2219 SW 74TH ST STE 109-115, OKLAHOMA CITY, OK 73159-3931
(405) 355-3239
Mailing address
6929 S SOONER RD APT 36201, OKLAHOMA CITY, OK 73135-2724
(903) 399-9688
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-335086
TX
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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