Individual
ERICIA LASHAY MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4731 JUDY DR, DEL CITY, OK 73115-3815
(405) 476-7732
Mailing address
PO BOX 1280, BETHANY, OK 73008-1280
(405) 397-7956
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/23/2024
Last updated
10/23/2024
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