Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013354828 |
---|---|
Provider Name | Veleecia Nicole Hearne |
First Address | Midwest City, OK 73110-3700 |
Second Address | Midwest City, OK 73110-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2013 |
Last Update Date | 03/06/2013 |