Individual
BRYANA RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
930 WALL ST, NORMAN, OK 73069-6319
(405) 384-8588
Mailing address
903 E MAGUIRE RD TRLR 140, NOBLE, OK 73068-8479
(580) 768-1573
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-397780
OK
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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