Individual
OLIVIA STANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
143 S THOMAS ST STE C, TUPELO, MS 38801-4349
(662) 840-0974
Mailing address
143 THOMAS STREET SUIT C, TUPELO, MS 38801
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-15-04095
MS
103K00000X
Behavior Analyst
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—
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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