Individual
MRS. JEANETTE ROSHELLE CARBAJAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
427 NE 115TH ST, OKLAHOMA CITY, OK 73114-7669
(405) 824-8577
Mailing address
427 NE 115TH ST, OKLAHOMA CITY, OK 73114-7669
(405) 824-8577
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
U082638764
OK
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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