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NPI Code Detail

MEDICARE: MRS. ALLISON CLANTON DEIMUND M.A., CCC-SLP

MEDICARE: MRS. ALLISON CLANTON DEIMUND M.A., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist5127OK

General Provider Information

NPI Number : 1053925040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALLISON CLANTON DEIMUND M.A., CCC-SLP
Provider Business Mailing Address
First Line : 908 NW 16TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-6404
Country : US
Telephone Number : 580-445-8312
Fax Number :
Provider Business Practice Location Address
First Line : 9201 S I 35 SERVICE RD
Second Line :
City : MOORE
State : OK
Zip : 73160-9046
Country : US
Telephone Number : 405-601-4303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2020
Last Update Date : 02/22/2021

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Directions to “ MRS. ALLISON CLANTON DEIMUND M.A., CCC-SLP” Practice Location

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