Individual
BROOKE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4917 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-6113
(405) 924-3134
Mailing address
4917 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-6113
(405) 924-3134
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200391400A
—
OK
Enumeration date
09/12/2011
Last updated
09/17/2014
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