Individual
MS. MARY ANN ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
513 S.W. BRUCE ST., LANGSTON, OK 73050
(405) 412-8020
Mailing address
PO BOX 1494, LANGSTON, OK 73050
(405) 466-9178
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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