Individual
GINA FLETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 W BROADWAY ST, OKEMAH, OK 74859-2618
(918) 623-2922
Mailing address
624 S FLORIDA AVE, OKMULGEE, OK 74447-7723
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
21607
NY
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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