Individual
KAYLIN PAIGE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 WILLOW RUN, ENID, OK 73703-1421
(580) 823-8017
Mailing address
1331 SUMMERS PL UNIT C, PONCA CITY, OK 74604-4441
(580) 576-0267
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-267112
OK
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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