Individual
BRYCE TAYLOR BLASINGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1817 COMMONS CIR STE A, YUKON, OK 73099-9522
(405) 467-6782
Mailing address
1824 COMMONS CIR STE B, YUKON, OK 73099-9538
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-454284
OK
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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