Individual
SANDRA L. REESE-KECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LPC
Contact information
Practice address
729 OVERLAND TRAIL, ENID, OK 73703
(580) 540-4163
(580) 294-5204
Mailing address
729 OVERLAND TRAIL, ENID, OK 73703
(580) 540-4163
(580) 294-5204
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6531
OK
103K00000X
Behavior Analyst
Primary
1-11-9464
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-11-9464
BEHAVIOR ANALYST CERTIFICATION BOARD
OK
05
—
200480230C
—
OK
05
—
200868590A
—
OK
01
—
6531
OKLAHOMA DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE
OK
Enumeration date
01/24/2012
Last updated
10/21/2024
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