Individual
MISS JENNIFER A MYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 SW 81ST ST, OKLAHOMA CITY, OK 73159-4733
(495) 819-1661
Mailing address
2601 SW 81ST ST, POX 673 GUTHRIE, OK 73044, OKLAHOMA CITY, OK 73159-4733
(405) 819-1661
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1003K00000X
OK
Other
Enumeration date
03/25/2011
Last updated
03/25/2011
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