Individual
REBECCA ELISE HEANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4209 NW 52ND ST, OKLAHOMA CITY, OK 73112-2111
(405) 702-3245
Mailing address
4209 NW 52ND ST, OKLAHOMA CITY, OK 73112-2111
(405) 702-3245
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-21-186829
OK
2355S0801X
Speech-Language Assistant
Primary
SLPA169
OK
Other
Enumeration date
03/02/2021
Last updated
11/18/2021
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