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General NPI Number Information
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NPI Number | 1740429562
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Entity Type | Organization
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Legal Business Name | SPLENDID SPEECH
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 32 HAZYBROOK CIR
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City | CHICKASHA
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State | OK
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Zip | 73018-7804
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Country | US
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Telephone | 405-819-4932
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Fax | 405-224-6411
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Provider Business Mailing Address
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Address Line | 32 HAZYBROOK CIR
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City | CHICKASHA
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State | OK
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Zip | 73018-7804
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Country | US
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Telephone | 405-819-4932
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Fax | 405-224-6411
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ASHLEY DAWN SHELL
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Credential | MS CCCSLP
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Telephone | 405-819-4932
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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 | 2113
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License Number State | OK
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