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Individual

KEVIN RIVAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15201A CROWN AT LONE OAK RD, EDMOND, OK 73013-2272
(479) 318-2300
Mailing address
15201A CROWN AT LONE OAK RD, EDMOND, OK 73013-2272
(479) 318-2300

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-375171
OK

Other

Enumeration date
09/13/2024
Last updated
09/13/2024
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