Individual
MACKENZIE LEE FRECH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
614 S MAIN ST, STILLWATER, OK 74074-4059
(405) 564-3408
Mailing address
13505 RIDGE DR, LAHOMA, OK 73754-9693
(580) 341-6283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-218123
OK
Other
Enumeration date
05/28/2022
Last updated
05/28/2022
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