Individual
JEREMY MALWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
330 W EDMOND RD, EDMOND, OK 73003-5600
(405) 202-6510
Mailing address
330 W EDMOND RD, EDMOND, OK 73003-5600
(405) 202-6510
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-21173
OK
Other
Enumeration date
08/09/2016
Last updated
02/19/2026
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