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Individual

MAKAYLA MARIE BERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1001 SW A AVE, LAWTON, OK 73501-3951
(580) 353-8900
Mailing address
1004 SE SULLIVAN DR, LAWTON, OK 73501-6555
(580) 951-3564

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/17/2023
Last updated
05/17/2023
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