Individual
LAUREN THORSTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
614 S MAIN ST, STILLWATER, OK 74074-4059
(405) 564-3408
Mailing address
11207 S 94TH EAST AVE, BIXBY, OK 74008-1777
(918) 625-3409
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-321345
OK
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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