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Organization
MAYES COUNTY SPEECH THERAPY SERVICES P.L.L.C.
Active
Organization
MAYES COUNTY SPEECH THERAPY SERVICES P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA MICHELL VAN HORN MS, CCC-SLP (SPEECH LANGUAGE PATHOLOGIST -OWNER)
(918) 640-6468
Entity
Organization
Contact information
Practice address
510 S ELLIOTT ST, PRYOR, OK 74361-6411
(918) 825-4837
Mailing address
510 S ELLIOTT ST, PRYOR, OK 74361-6411
(918) 825-4837
(918) 825-4644
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3168
OK
Other
Enumeration date
03/04/2007
Last updated
12/07/2007
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