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General NPI Number Information
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NPI Number | 1164328027
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Entity Type | Organization
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Legal Business Name | ENVISION THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 10/16/2026
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Last Update Date | 10/16/2026
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Provider Practice Location Address
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Address Line | 112 N BLAINE AVE UNIT B
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City | CHANDLER
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State | OK
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Zip | 74834-1216
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Country | US
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Telephone | 405-258-8857
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Fax |
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Provider Business Mailing Address
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Address Line | 346613 E 860 RD
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City | CHANDLER
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State | OK
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Zip | 74834-9635
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Country | US
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Telephone | 405-258-8857
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | ALANNA CLARK
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Credential | M.S. CCC-SLP
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Telephone | 405-258-8857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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