Individual
JACKIE LYNN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2215 NW CACHE RD, SUITE 107, LAWTON, OK 73505-5239
(580) 351-9998
(580) 351-9898
Mailing address
4519 NW CHEYENNE AVE, LAWTON, OK 73505-3244
(580) 301-4839
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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