Individual
JAELYN NICOLE GIRTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
614 S MAIN ST, STILLWATER, OK 74074-4059
(405) 564-3408
Mailing address
18742 S BUTLER RD, TAHLEQUAH, OK 74464-1238
(918) 708-5670
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/17/2024
Last updated
05/17/2024
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