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General NPI Number Information
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NPI Number | 1578114591
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Entity Type | Organization
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Legal Business Name | OK PEDS PEDIATRIC THERAPY SERVICES
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 7301 S HARRAH RD
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City | NEWALLA
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State | OK
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Zip | 74857-7912
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Country | US
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Telephone | 405-659-6390
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Fax | 855-933-0242
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Provider Business Mailing Address
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Address Line | 7301 S HARRAH RD
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City | NEWALLA
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State | OK
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Zip | 74857-7912
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Country | US
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Telephone | 405-659-6390
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Fax | 855-933-0242
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | SEIRRA LEWELLING
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Credential | M.S. CCC-SLP/L
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Telephone | 405-659-6390
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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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