Individual
KAYLA LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4636 S HARVARD AVE, TULSA, OK 74135-2908
(918) 216-4917
Mailing address
1702 OAKVIEW RD, OKMULGEE, OK 74447-7145
(405) 742-2929
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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