Individual
JUSTIN SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9813 SW 33RD ST, YUKON, OK 73099-3494
(405) 436-3930
Mailing address
9813 SW 33RD ST, YUKON, OK 73099-3494
(405) 436-3930
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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