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Organization
WYATT SPEECH THERAPY SERVICES, PLLC
Active
Organization
WYATT SPEECH THERAPY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SASHA WYATT M.S., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(918) 931-3171
Entity
Organization
Contact information
Practice address
407 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4427
(918) 931-3171
(877) 540-0882
Mailing address
26399 S 515 RD, PARK HILL, OK 74451
(918) 207-9073
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770854879
—
OK
Enumeration date
09/20/2021
Last updated
09/20/2021
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