Individual
KACIE N HUMBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
425 S FRETZ AVE STE C425S, EDMOND, OK 73003-5532
(405) 757-7980
Mailing address
425 S FRETZ AVE STE C, EDMOND, OK 73003-5568
(405) 757-7980
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
10/01/2024
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