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NPI Code Detail

MEDICARE: CHRISTINA MARIE MCDOUGALL M.A., CCC-SLP

MEDICARE: CHRISTINA MARIE MCDOUGALL M.A., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist4409OK

General Provider Information

NPI Number : 1528764479
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA MARIE MCDOUGALL M.A., CCC-SLP
Provider Business Mailing Address
First Line : 3704 WOOD CASTLE ST
Second Line :
City : NORMAN
State : OK
Zip : 73072-1746
Country : US
Telephone Number : 405-314-2355
Fax Number :
Provider Business Practice Location Address
First Line : 7217 SE 15TH ST
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-5235
Country : US
Telephone Number : 405-737-4461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2023
Last Update Date : 02/02/2023

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Directions to “ CHRISTINA MARIE MCDOUGALL M.A., CCC-SLP” Practice Location

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