Individual
DEIRDRE COLLEEN FUDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. CCC-SLP
Contact information
Practice address
3341 NW 19TH ST, OKLAHOMA CITY, OK 73107-3827
(405) 314-7408
Mailing address
3341 NW 19TH ST, OKLAHOMA CITY, OK 73107-3827
(405) 314-7408
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2681
OK
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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