Individual
SAVANNA LEANN MACOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2603 LONNIE LN, OKLAHOMA CITY, OK 73170-7481
(405) 708-0863
Mailing address
2603 LONNIE LN, OKLAHOMA CITY, OK 73170-7481
(405) 708-0863
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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