Most Relevant Information
Provider Data
NPI Number: | 1003042771 |
Provider Name: | CODI RENNE CANNING B.S./ CBHCM |
Entity Type: | Individual |
Taxonomy Code: | 103K00000X |
Specialty: | Behavior Analyst |
License Number: |
Most Important Dates
Enumeration Date: | 06/08/2009 |
Last Updated: | 06/08/2009 |
Provider Practice Location
4710 S DIVISION ST
GUTHRIE
OK
730446506
Practice Location Phone/Fax
Phone: | 4052825524 |
Fax: | 4052824652 |
Provider Mailing Location
4710 S DIVISION ST
PO BOX 1558
GUTHRIE
OK
730446506
Provider Mailing Phone/Fax
Phone: | 4052825524 |
Fax: | 4052824652 |