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Individual

KYLA JOANN PEBWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1717 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-5103
(405) 622-4239
Mailing address
1717 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-5103
(405) 622-4239

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-483023
OK

Other

Enumeration date
10/23/2025
Last updated
10/24/2025
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