Individual
BRANDON BANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1012 24TH AVE NW STE 100, NORMAN, OK 73069-6493
(855) 223-7123
Mailing address
PO BOX 33568, SAN DIEGO, CA 92163-3568
(855) 223-7123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73358
OK
106E00000X
Assistant Behavior Analyst
0-23-14245
OK
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/28/2021
Last updated
06/24/2024
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