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Individual

NICOLE PHARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
1121 S DOUGLAS BLVD STE A, MIDWEST CITY, OK 73130-5210
(405) 582-3990
Mailing address
1121 S DOUGLAS BLVD STE A, MIDWEST CITY, OK 73130-5210
(405) 582-3990

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21183377
OK

Other

Enumeration date
09/22/2021
Last updated
09/22/2021
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