Individual
LISA EDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 SMOKING TREE ST, MOORE, OK 73160-5718
(304) 991-2344
Mailing address
1500 SMOKING TREE ST, MOORE, OK 73160-5718
(304) 991-2344
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-50981
OK
Other
Enumeration date
06/25/2021
Last updated
09/30/2024
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