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Individual

DR. BONNIE L PENDLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D., M.S., M.A.

Contact information

Practice address
4301 WILSON ST, FORT SILL, OK 73503-4472
(580) 558-8424
Mailing address
4301 WILSON ST, FORT SILL, OK 73503-4472
(580) 558-8424

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
239
OK
235Z00000X
Speech-Language Pathologist
2133
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100657760A
OK
05
100657760E
OK
05
100657760F
OK
Enumeration date
10/05/2006
Last updated
12/26/2023
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