Individual
AUTUM LOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
310 W WASHINGTON ST STE D, PURCELL, OK 73080-4230
(405) 609-4618
(405) 310-0679
Mailing address
18550 144TH ST, LEXINGTON, OK 73051-6803
(405) 609-4618
(405) 310-0679
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4426
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4426
STATE LICENSE
OK
Enumeration date
02/03/2023
Last updated
02/03/2023
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