Individual
REINA CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11982 S MULBERRY CT, JENKS, OK 74037-2181
(918) 201-1865
Mailing address
2701 LAKE JACKSON RD, MOUNDS, OK 74047-4204
(432) 553-3762
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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