Individual
JUDY ELAINE MCINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2645 RAINTREE CIR, SAPULPA, OK 74066-9351
(918) 770-1876
Mailing address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 227-2016
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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