Individual
LIESL HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2248 NW 164TH ST, EDMOND, OK 73013-8801
(405) 562-3776
Mailing address
2248 NW 164TH ST, EDMOND, OK 73013-8801
(405) 562-3776
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-283646
—
Other
Enumeration date
08/11/2023
Last updated
11/13/2023
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