Individual
SHERRY BUZZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 N BROADWAY ST, POTEAU, OK 74953-2050
(918) 721-0380
Mailing address
210 OAK ST, POTEAU, OK 74953-2339
(918) 721-0380
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200497090A
—
OK
Enumeration date
11/01/2013
Last updated
11/01/2013
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