Individual
MRS. ALICIA RENEE BRANUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. ED. BCBA
Contact information
Practice address
810 W CHEYENNE ST, MARLOW, OK 73055-3067
(580) 641-2527
Mailing address
810 W CHEYENNE ST, MARLOW, OK 73055-3067
(580) 641-2527
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11416511
OK
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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