Individual
BENJAMIN BRADLEY EMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,CCC-SLP
Contact information
Practice address
1101 RED BUD LN, EDMOND, OK 73034-8040
(405) 308-8146
Mailing address
1101 RED BUD LN, EDMOND, OK 73034-8040
(405) 308-8146
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3190
OK
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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