Individual
MADISON OLIVIA IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1810 E 15TH ST STE A, TULSA, OK 74104-4656
(918) 410-9668
Mailing address
1810 E 15TH ST, TULSA, OK 74104-4633
(918) 410-9668
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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