Individual
SAGE OKSANA - RENEE JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2322
Mailing address
920 UNIVERSITY DR, RUSSELLVILLE, AR 72801-4303
(479) 967-2322
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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