Healthcare Provider Details

I. General information

NPI: 1912818253
Provider Name (Legal Business Name): KARSAN RENEE VICK M.S., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 S KINGS ST
STILLWATER OK
74074-2855
US

IV. Provider business mailing address

2123 W 30TH AVE
STILLWATER OK
74074-2756
US

V. Phone/Fax

Practice location:
  • Phone: 405-533-6370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCF973
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: