Healthcare Provider Details

I. General information

NPI: 1831677970
Provider Name (Legal Business Name): ELLEN CLAIRE PLAGG MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13819 QUAIL POINTE DR
OKLAHOMA CITY OK
73134-1066
US

IV. Provider business mailing address

1824 COMMONS CIR STE B
YUKON OK
73099-9538
US

V. Phone/Fax

Practice location:
  • Phone: 405-467-6782
  • Fax: 405-467-6100
Mailing address:
  • Phone: 405-467-6782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2018024937
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number5582
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: