Individual
JESSICA D ROUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3005 SW PARK AVE, LAWTON, OK 73505-7902
(580) 699-5558
(580) 699-5559
Mailing address
3005 SW PARK AVE, LAWTON, OK 73505-7902
(580) 699-5558
(580) 699-5559
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT21171568
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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