Healthcare Provider Details

I. General information

NPI: 1588494413
Provider Name (Legal Business Name): MACEY LYNN FUCHS M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SE 2ND ST
BLANCHARD OK
73010-5529
US

IV. Provider business mailing address

1512 W OAK ST
EL RENO OK
73036-4958
US

V. Phone/Fax

Practice location:
  • Phone: 405-779-3270
  • Fax:
Mailing address:
  • Phone: 580-210-9906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: