Individual
JAMIE LYNN HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 S CENTRAL AVE, IDABEL, OK 74745-4625
(580) 353-9726
(580) 271-6790
Mailing address
2300 BELPINE LOOP, BROKEN BOW, OK 74728-5833
(580) 236-4147
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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