Individual
KRISTA FERTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1810 E 15TH ST STE A, TULSA, OK 74104-4611
(918) 410-9668
(918) 512-4816
Mailing address
1810 E 15TH ST STE A, TULSA, OK 74104-4611
(918) 410-9668
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB707690
OK
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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