Individual
MRS. LISA REBECCA YEAKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3712 E 83RD ST, TULSA, OK 74137-1703
(918) 704-2760
Mailing address
9815 S 225TH EAST AVE, BROKEN ARROW, OK 74014-5928
(918) 232-2536
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF249
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
OK
Enumeration date
04/27/2013
Last updated
07/30/2020
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