Individual
BRIANA J'LISE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1960 HARPER ST, CHOCTAW, OK 73020-8095
(405) 281-1040
(405) 987-1070
Mailing address
15201 CROWN AT LONE OAK RD UNIT A, EDMOND, OK 73013-2272
(919) 525-7437
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-300574
OK
Other
Enumeration date
10/11/2023
Last updated
07/07/2025
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