| NPI | 1316060130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAROL K RIDEOUT Member 918-809-3745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OK 2908) |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2020-08-22 |