Individual
MIA ROSE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1106 N 155TH ST STE B, BASEHOR, KS 66007-7100
(913) 662-7071
Mailing address
2210 24TH AVE NW, NORMAN, OK 73069-6496
(405) 857-8280
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/06/2022
Last updated
03/20/2025
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