Individual
TRACY HEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 452-3335
Mailing address
14 QUAIL RDG, SHAWNEE, OK 74804-3228
(405) 443-7379
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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