Individual
KATIE BETH LUTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
11239 N 112TH EAST AVE, OWASSO, OK 74055-4220
(918) 607-7151
Mailing address
11239 N 112TH EAST AVE, OWASSO, OK 74055-4220
(918) 607-7151
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3780
OK
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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