Individual
MACKENNA LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT, COTA/L
Contact information
Practice address
1806 24TH AVE NW, NORMAN, OK 73069-6392
(405) 857-8280
(405) 857-8489
Mailing address
1806 24TH AVE NW, NORMAN, OK 73069-6392
(405) 857-8280
(405) 857-8489
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT20135901
OK
Other
Enumeration date
09/17/2020
Last updated
06/27/2022
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