Individual
ALISSA ANTWINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11512 BUCKINGHAM CT, YUKON, OK 73099-8100
(405) 818-4107
Mailing address
11512 BUCKINGHAM CT, YUKON, OK 73099-8100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/16/2014
Last updated
03/16/2014
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