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1043304132
CICELY FANNING
BROKEN ARROW, OK
NPI
1043304132
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: OK 12094555)
Enumeration Date
2006-10-03
Last Update Date
2007-07-08
Business Address
-- CICELY FANNING
2208 N YELLOWOOD AVE
BROKEN ARROW, OK 74012-9102
Phone number: 918-286-1261
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Mailing Address
-- CICELY FANNING
2208 N YELLOWOOD AVE
BROKEN ARROW, OK 74012-9102
Phone number: 918-286-1261
Copy
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