Individual
JAIDA S BETHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 PARK AVE, OKLAHOMA CITY, OK 73102-7209
(402) 252-1363
Mailing address
101 PARK AVE, OKLAHOMA CITY, OK 73102-7209
(402) 252-1363
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-286668
OK
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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