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General NPI Number Information
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NPI Number | 1326664368
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Entity Type | Organization
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Legal Business Name | STATON HOUSE
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 06/24/2020
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Provider Practice Location Address
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Address Line | 1100 E WHISPERING OAKS TER
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City | MUSTANG
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State | OK
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Zip | 73064-4870
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Country | US
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Telephone | 405-426-7031
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Fax | 888-646-6057
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Provider Business Mailing Address
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Address Line | 1100 E WHISPERING OAKS TER
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City | MUSTANG
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State | OK
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Zip | 73064-4870
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Country | US
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Telephone | 405-426-7031
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Fax | 888-646-6057
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Authorized Official
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Title or Position | OWNER
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Name | MARCY STATON
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Credential | SLP
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Telephone | 405-426-7031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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