Individual
JAQUALYNN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 W MAIN ST, ANTLERS, OK 74523-2059
(580) 209-6111
Mailing address
1402 W MAIN ST, ANTLERS, OK 74523-2059
(580) 209-6111
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-239159
OK
Other
Enumeration date
10/11/2022
Last updated
10/12/2022
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