Doctor Name: | KRISTIN RODGERS |
NPI Number: | 1346696804 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 4502 |
Business Practice Address: | 1500 Sw 104th St Suite 102 Oklahoma City, OK - 731597661 |
Business Phone Number: | 4057356222 |
Business Fax Number: | |
Mailing Address: | 605 Eastridge Dr, YUKON |
State: | OK |
Postal Code: | 730990901 |
Phone Number: | 6262338160 |
Fax Number: | |
NPI Enumeration Date: | 05/13/2016 |
NPI Last Update Date: | 05/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4502 |
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 |