Healthcare Provider Details

I. General information

NPI: 1871411272
Provider Name (Legal Business Name): AMY RENEE AHYO C-SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 TINKER DIAG ST
DEL CITY OK
73115-1017
US

IV. Provider business mailing address

4304 COLT DR
MUSTANG OK
73064-1094
US

V. Phone/Fax

Practice location:
  • Phone: 405-862-6065
  • Fax: 405-931-0016
Mailing address:
  • Phone: 405-862-6065
  • Fax: 405-931-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA445
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: