Individual
LAVONNE RENAE BATES-CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3004 NW 68TH ST, OKLAHOMA CITY, OK 73116-3206
(405) 837-4312
Mailing address
3004 NW 68TH ST, OKLAHOMA CITY, OK 73116-3206
(405) 837-4312
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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