Individual
BENNISA MICHELLE BURRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5555 S LEWIS AVE, TULSA, OK 74105-7104
(918) 779-4556
Mailing address
2624 N QUINCY AVE, TULSA, OK 74106-2604
(918) 949-1904
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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