Individual
HALEY SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3501 W KENOSHA ST, BROKEN ARROW, OK 74012-8948
(918) 994-2764
Mailing address
3501 W KENOSHA ST, BROKEN ARROW, OK 74012-8948
(918) 992-2764
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79216
OK
106S00000X
Behavior Technician
RBT-21-171045
OK
Other
Enumeration date
06/11/2021
Last updated
02/07/2025
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