Individual
MEGAN ANNE RUSSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 N MAIN ST, MIAMI, OK 74354-3322
(918) 542-6655
Mailing address
1227 N MAIN ST, MIAMI, OK 74354-3322
(918) 542-6655
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200745910A
—
OK
Enumeration date
08/06/2021
Last updated
08/06/2021
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