Individual
KELSEY LYN BIGHEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 LIBERTY LN, EDMOND, OK 73034-9432
(405) 714-4290
Mailing address
1313 SHUMARD CT, STILLWATER, OK 74074-1532
(405) 714-4290
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
L083501454
OK
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
L083501454
OK
Other
Enumeration date
07/23/2019
Last updated
09/06/2022
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