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General NPI Number Information
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NPI Number | 1588380737
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Entity Type | Organization
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Legal Business Name | PANKALLA SPEECH AND LANGUAGE LLC
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 5933 REGIS CT
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City | EDMOND
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State | OK
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Zip | 73034-8010
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Country | US
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Telephone | 405-550-5691
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Fax | 405-906-3690
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Provider Business Mailing Address
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Address Line | 5933 REGIS CT
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City | EDMOND
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State | OK
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Zip | 73034-8010
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Country | US
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Telephone | 405-550-5691
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Fax | 405-562-6621
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | LYNN MARIE PANKALLA
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Credential | M.ED., CCC-SLP
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Telephone | 405-550-5691
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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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