IndividualActive
Angelica Russell
NPI 1245925023 · Behavior Technician · Jenks, OK
Provider details
- NPI number
- 1245925023
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
11982 S Mulberry Ct
Jenks, OK 74037-2181
Phone: (539) 777-0940
Approximate (ZIP-level) locationGet directions
Mailing address
516 W 147th Pl S
Glenpool, OK 74033-4349
Registry dates
- Enumerated
- 2023-04-07
- Last updated
- 2025-09-03
- Certified
- 2025-09-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.