Individual
REGINALD ANTHONY RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10020 NW 142ND ST, YUKON, OK 73099-1334
(405) 802-9884
Mailing address
10020 NW 142ND ST, YUKON, OK 73099-1334
(405) 802-9884
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-315680
OK
Other
Enumeration date
11/17/2009
Last updated
12/20/2023
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