Individual
BRANDIANNE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 W MAPLE AVE, ENID, OK 73701-4027
(580) 234-8865
Mailing address
2825 CONSTITUTION AVE, ENID, OK 73703-1345
(580) 748-1129
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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