Individual
MS. LEISA ANN BAUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11740 E 21ST, TULSA, OK 74129
(918) 437-9495
Mailing address
1202 N WILLOW DR, UNIT A, CLAREMORE, OK 74017
(918) 629-8407
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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