Individual
RIAN LYNN WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1713 ANN AVE, PONCA CITY, OK 74604-2504
(580) 304-6039
Mailing address
1713 ANN AVE, PONCA CITY, OK 74604-2504
(580) 304-6039
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
40868
CA
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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