Individual
AMY CLEMENCEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6905 NW 122ND ST, OKLAHOMA CITY, OK 73142-3903
(405) 603-6622
(405) 722-3244
Mailing address
6905 NW 122ND ST, OKLAHOMA CITY, OK 73142-3903
(405) 603-6622
(405) 722-3244
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-182210
OK
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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