Organization Name: | CANADIAN VALLEY SPEECH SERVICES |
NPI Number: | 1891118063 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANN MICHELE BURRIS (SPEECH LANGUAGE PATHOLOGIST) |
Mailing Address: | 1100 N Mustang Rd Mustang |
State: | OK US |
Postal Code: | 730647201 |
Phone Number: | 4058304023 |
Fax Number: | 4053245536 |
NPI Enumeration Date: | 01/23/2014 |
NPI Last Update Date: | 04/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2837 |
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 |