Individual
DEIDRA RACHELLE MEREDITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
647 N KICKAPOO AVE, SHAWNEE, OK 74801-6063
(405) 214-0933
Mailing address
PO BOX 632, KREBS, OK 74554-0632
(918) 470-2862
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/13/2010
Last updated
12/13/2010
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