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General NPI Number Information
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NPI Number | 1073686564
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Entity Type | Organization
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Legal Business Name | THAYNE A HEDGES REGIONAL SPEECH AND HEARING CENTER INC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 2615 E RANDOLPH AVE
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City | ENID
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State | OK
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Zip | 73701-4670
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Country | US
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Telephone | 580-234-3734
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Fax | 580-234-2615
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Provider Business Mailing Address
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Address Line | 2615 E RANDOLPH AVE
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City | ENID
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State | OK
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Zip | 73701-4670
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Country | US
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Telephone | 580-234-3734
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Fax | 580-234-2615
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Authorized Official
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Title or Position | EXEC DIRECTOR
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Name | CARMEN M BALL
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Credential |
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Telephone | 580-234-3734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 90
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2181
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 114
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2948
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 53
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2571
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License Number State | OK
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