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Individual

AUDREA EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1814 W OWEN K GARRIOTT RD, ENID, OK 73703-5525
(580) 823-8017
Mailing address
1217 W MCALESTER AVE, SULPHUR, OK 73086-5445
(580) 618-3401

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB646004
OK

Other

Enumeration date
06/13/2021
Last updated
06/13/2021
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