Individual
DIMANIQUE T GRANADOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13821 TECHNOLOGY DR # A1, OKLAHOMA CITY, OK 73134-1045
(539) 777-0940
Mailing address
520 SE 47TH ST, OKLAHOMA CITY, OK 73129-5328
(580) 471-3476
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/06/2022
Last updated
03/06/2022
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