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1912451840
JEREMY MALWICK
EDMOND, OK
NPI
1912451840
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: OK 1-15-21173)
Enumeration Date
2016-08-09
Last Update Date
2016-08-09
Business Address
-- JEREMY MALWICK BCBA
1301 PINE OAK DR
EDMOND, OK 73034-5446
Phone number: 405-202-6510
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Mailing Address
-- JEREMY MALWICK BCBA
PO BOX 2164
EDMOND, OK 73083-2164
Phone number: 405-202-6510
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