Individual
BRENDA J HICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201440 E COUNTY ROAD 31, WOODWARD, OK 73801-5080
(580) 334-8701
Mailing address
201440 E COUNTY ROAD 31, WOODWARD, OK 73801-5080
(580) 334-8701
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-242343
OK
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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