Organization
FREEBORN DYSPHAGIA ASSOCIATES, LLC
Active
Other names
Heart of Oklahoma Center for Swallow & Speech Services
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA ALYCIA FREEBORN MA CCC SLP (CEO/ OWNER)
(405) 609-4618
Entity
Organization
Contact information
Practice address
120 S LESTER LANE, PURCELL, OK 73080-5451
(405) 766-1238
(405) 310-0679
Mailing address
18550 144TH ST, LEXINGTON, OK 73051-6803
(405) 766-1238
(405) 310-0679
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
—
—
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14002787
ASHA
—
01
—
19013
CALIFORNIA STATE LICENSE
CA
05
—
200952980A
—
OK
01
—
4171
OKLAHOMA SLP
OK
Enumeration date
11/05/2019
Last updated
06/28/2024
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