Ethan Bruce

NPI #1760099121 in Tulsa, Oklahoma

Provider Information

NPI Number: 1760099121
Entity Type: Individual
Name: Ethan Bruce
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Sep 29, 2020
Last Updated: Sep 22, 2021

Practice Location

Address: 4908 S SHERIDAN RD
City: Tulsa
State: Oklahoma
ZIP Code: 74145-5712
Phone: (918) 984-9153

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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