Individual
MICHA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14828 SERENITA AVE, OKLAHOMA CITY, OK 73142
(405) 839-7300
Mailing address
1730 ANDOVER CT, OKLAHOMA CITY, OK 73120-1102
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-80700
OK
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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