Individual
CODIE HOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1809 COMMONS CIR STE B, YUKON, OK 73099-9528
(405) 467-4551
(405) 324-0971
Mailing address
1300 NW 15TH ST, OKLAHOMA CITY, OK 73106-4427
(469) 531-3043
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-133747
OK
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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