Healthcare Provider Details

I. General information

NPI: 1730875451
Provider Name (Legal Business Name): SAVANNAH DRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E COPLIN ST
OKEMAH OK
74859-4648
US

IV. Provider business mailing address

32890 S 321ST WEST AVE
BRISTOW OK
74010-4215
US

V. Phone/Fax

Practice location:
  • Phone: 918-623-1424
  • Fax:
Mailing address:
  • Phone: 918-423-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCF870
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: