| Organization Name: | IDWI, INC |
| NPI Number: | 1679738082 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOE'L EDINGTON FARRAR (PRES) |
| Mailing Address: | 2864 Sw Limestone Rd Wilburton |
| State: | OK US |
| Postal Code: | 745786843 |
| Phone Number: | 9186375114 |
| Fax Number: | 9184653095 |
| NPI Enumeration Date: | 07/24/2008 |
| NPI Last Update Date: | 10/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |