Healthcare Provider Details

I. General information

NPI: 1922644434
Provider Name (Legal Business Name): BRITANY NICOLE LAKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 COMMONS CIR STE A
YUKON OK
73099-9538
US

IV. Provider business mailing address

1824 COMMONS CIR STE A
YUKON OK
73099-9538
US

V. Phone/Fax

Practice location:
  • Phone: 405-467-6782
  • Fax:
Mailing address:
  • Phone: 405-467-6782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-62679
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-91618
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: