Individual
PHOENIX RAYNE CRISMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
416 W 15TH ST STE 600, EDMOND, OK 73013-3672
(479) 318-2300
Mailing address
14300 N MAY AVE APT 15204, OKLAHOMA CITY, OK 73134-5047
(734) 934-0262
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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