Individual
AMANDA N RUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19320 E ADMIRAL PL STE B, CATOOSA, OK 74015-3240
(918) 340-5503
Mailing address
1772 N 4364, PRYOR, OK 74361-2793
(918) 803-3140
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
08/27/2021
Last updated
10/07/2024
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