Healthcare Provider Details

I. General information

NPI: 1669272936
Provider Name (Legal Business Name): LAUREN MATHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13401 RAILWAY DR
OKLAHOMA CITY OK
73114-2272
US

IV. Provider business mailing address

13401 RAILWAY DR
OKLAHOMA CITY OK
73114-2272
US

V. Phone/Fax

Practice location:
  • Phone: 405-841-7826
  • Fax: 405-841-7827
Mailing address:
  • Phone: 405-841-7826
  • Fax: 405-841-7827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: