Organization
SPROUT BEHAVIOR AND SKILLS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REISHA DESPAIN BCBA (OWNER)
(405) 887-5719
Entity
Organization
Contact information
Practice address
5717 NW 115TH ST, OKLAHOMA CITY, OK 73162-3545
(405) 887-5719
Mailing address
5717 NW 115TH ST, OKLAHOMA CITY, OK 73162-3545
(405) 887-5719
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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