Individual
DARLENE IRIS STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 N UNION AVE, SHAWNEE, OK 74801-7067
(405) 275-7100
Mailing address
1504 WILSHIRE DRIVE, PRAGUE, OK 74864-0000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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