Individual
GRACIE WOODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13913 S WESTERN AVE, OKLAHOMA CITY, OK 73170-7011
(405) 445-5567
Mailing address
1800 BEAUMONT DR APT 1123, NORMAN, OK 73071-2291
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-418760
OK
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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