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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