Individual
MR. MARVIN ODIE RIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
808 NW 115TH ST, OKLAHOMA CITY, OK 73114-6900
(405) 808-9105
(405) 216-5272
Mailing address
808 NW 115TH ST, OKLAHOMA CITY, OK 73114-6900
(405) 808-9105
(405) 216-5272
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200123000A
—
OK
Enumeration date
02/05/2010
Last updated
02/05/2010
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