Individual
DEMETRIUS LARON ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2322 CEDAR BROOK DR, MOORE, OK 73160-8929
(405) 831-7365
Mailing address
2322 CEDAR BROOK DR, MOORE, OK 73160-8929
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
OK
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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