Koen Jacob Myrick

NPI #1477249506 in Vinita, Oklahoma

Provider Information

NPI Number: 1477249506
Entity Type: Individual
Name: Koen Jacob Myrick
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 12, 2023
Last Updated: Apr 12, 2023

Practice Location

Address: 116 S WILSON ST
City: Vinita
State: Oklahoma
ZIP Code: 74301-3730
Phone: (918) 542-4101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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