Individual
MRS. JESSICA R MARDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
5744 E 63RD PL, TULSA, OK 74136-2715
(918) 640-8221
Mailing address
5744 E 63RD PL, TULSA, OK 74136-2715
(918) 640-8221
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3379
OK
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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