Individual
HEATHER RANEE ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 W KENOSHA ST, BROKEN ARROW, OK 74012-8948
(855) 782-7822
Mailing address
3501 W KENOSHA ST, BROKEN ARROW, OK 74012-8948
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/04/2020
Last updated
01/20/2021
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