Provider Demographics
NPI:1063302289
Name:STINSON, DEJAH (RBT-24-337260)
Entity type:Individual
Prefix:
First Name:DEJAH
Middle Name:
Last Name:STINSON
Suffix:
Gender:F
Credentials:RBT-24-337260
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 PALMER CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2405 PALMER CIR STE 1002405
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6349
Practice Address - Country:US
Practice Address - Phone:702-742-6550
Practice Address - Fax:346-698-2900
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician