Individual
HEATHER RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E MEMORIAL RD STE 700, OKLAHOMA CITY, OK 73114-2287
(913) 850-5934
Mailing address
401 E MEMORIAL RD STE 700, OKLAHOMA CITY, OK 73114-2287
(800) 345-0448
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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