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General NPI Number Information
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NPI Number | 1487022851
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Entity Type | Organization
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Legal Business Name | SPEECH AND BEYOND MH
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 9224 S ELWOOD AVE STE A
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City | JENKS
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State | OK
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Zip | 74037-2364
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Country | US
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Telephone | 918-409-0157
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Fax | 918-209-4788
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Provider Business Mailing Address
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Address Line | 9224 S ELWOOD AVE STE A
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City | JENKS
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State | OK
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Zip | 74037-2364
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Country | US
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Telephone | 918-409-0157
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Fax | 918-209-4788
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Authorized Official
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Title or Position | OWNER
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Name | SARAH M KOEHLING
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Credential | CCC-SLP
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Telephone | 918-409-0157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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