Individual
KALEAH WHITNI JADE MOATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2801 WASHINGTON DRIVE, NORMAN, OK 73069
(405) 561-5512
Mailing address
2801 WASHINGTON DRIVE, NORMAN, OK 73069
(405) 561-5512
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-196846
OK
Other
Enumeration date
12/21/2021
Last updated
12/21/2021
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