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Organization

RED RIVER BEHAVIORAL SPECIALISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SEAN PATRICK PETERSON PHD, BCBA (OWNER)
(661) 714-8068
Entity
Organization

Contact information

Practice address
5737 NW 132ND ST, OKLAHOMA CITY, OK 73142-4437
(661) 714-8068
Mailing address
PO BOX 720070, OKLAHOMA CITY, OK 73172-0070

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-15033
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-13-15033
LBA
OK
Enumeration date
11/09/2017
Last updated
11/09/2017
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