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Individual

SHANNON RODEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED., SLP

Contact information

Practice address
1604 S SEMINOLE AVE, WEWOKA, OK 74884-3923
(918) 413-9710
Mailing address
1831 AIRPORT DR, SHAWNEE, OK 74804-2640
(405) 273-3388
(405) 273-3389

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
218163
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
218163
CERTIFICATION FOR SPEECH LANGUAGE PATHOLOGY IN THE SCHOOL
OK
Enumeration date
02/06/2017
Last updated
02/06/2017
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