Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013204700 |
---|---|
Provider Name | Miss Lynette Louise Jones |
First Address | Edmond, OK 73013-1954 |
Second Address | Edmond, OK 73013-1952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 01/07/2011 |