Organization
MARYLEE GASKINS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYLEE NANNELL GASKINS (SELF)
(918) 272-5326
Entity
Organization
Contact information
Practice address
302 E 19TH ST, OWASSO, OK 74055-4612
(918) 272-5326
Mailing address
302 E 19TH ST, OWASSO, OK 74055-4612
(918) 272-5326
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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