Individual
MRS. DIANA BETH DORETY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1909 VICTORIA PL, EDMOND, OK 73003-3865
(405) 606-5768
(405) 917-5595
Mailing address
1909 VICTORIA PL, EDMOND, OK 73003-3865
(405) 341-1987
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3839
OK
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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