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Individual

RYAN MACMILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 PARK AVE STE 1300, OKLAHOMA CITY, OK 73102-7216
(844) 743-6506
Mailing address
8300 JEFFERSON ST NE STE B, ALBUQUERQUE, NM 87113-1734

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/01/2022
Last updated
05/01/2022
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