Individual
MIKA REDWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3635 NW 39TH ST, OKLAHOMA CITY, OK 73112-6309
(405) 985-9045
Mailing address
915 ELM AVE, YUKON, OK 73099-2434
(405) 985-9045
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
03/28/2025
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