Healthcare Provider Details

I. General information

NPI: 1609793108
Provider Name (Legal Business Name): MAISON PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 E 9TH ST STE C
EDMOND OK
73034-3911
US

IV. Provider business mailing address

26 E 9TH ST STE C
EDMOND OK
73034-3911
US

V. Phone/Fax

Practice location:
  • Phone: 337-965-0584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA SAVOIE
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: MS CCC-SLP
Phone: 337-965-0584