Doctor Name: | MRS. TERA LEANN UNDERWOOD |
NPI Number: | 1144558677 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | 2431 |
Business Practice Address: | 604 S Classen Ave #a Moore, OK - 731605401 |
Business Phone Number: | 4057356333 |
Business Fax Number: | |
Mailing Address: | 1120 Sw 129th St, OKLAHOMA CITY |
State: | OK |
Postal Code: | 731706991 |
Phone Number: | 4056916074 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2009 |
NPI Last Update Date: | 11/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2431 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |