Individual
LASANDRA MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10128 CATON PL, MIDWEST CITY, OK 73130-1611
(405) 204-5969
Mailing address
10128 CATON PL, MIDWEST CITY, OK 73130-1611
(405) 204-5969
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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