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Individual

CRYSTAL A ORANGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
804 W CHOCTAW AVE, CHICKASHA, OK 73018-2310
(405) 222-0622
(405) 224-9532
Mailing address
804 W CHOCTAW, CHICKASHA, OK 73018
(405) 222-0622
(405) 224-9532

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
OK

Other

Enumeration date
09/29/2010
Last updated
09/29/2010
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