Individual
MRS. KIM ELIZABETH MACY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6128 E 38TH ST STE 400, TULSA, OK 74135-5808
(918) 835-8691
(918) 836-4505
Mailing address
10013 S 100TH EAST PL, TULSA, OK 74133-5188
(918) 625-2428
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1085
OK
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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