Marissa Lea Lickteig

NPI #1336023241 in Tulsa, Oklahoma

Provider Information

NPI Number: 1336023241
Entity Type: Individual
Name: Marissa Lea Lickteig
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Aug 4, 2025
Last Updated: Aug 4, 2025

Practice Location

Address: 4908 S SHERIDAN RD
City: Tulsa
State: Oklahoma
ZIP Code: 74145-5712
Phone: (918) 984-9513

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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