Provider Demographics
NPI:1508759168
Name:POTEET, DERYN (RBT)
Entity type:Individual
Prefix:
First Name:DERYN
Middle Name:
Last Name:POTEET
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 NE 63RD ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-1402
Mailing Address - Country:US
Mailing Address - Phone:405-414-2067
Mailing Address - Fax:405-288-7473
Practice Address - Street 1:6 NE 63RD ST STE 110
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-1402
Practice Address - Country:US
Practice Address - Phone:405-414-2067
Practice Address - Fax:405-288-7473
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRBT-25-439794106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician