Organization
MULTIPLE COMMUNICATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON NICOLE MIZE SLP (SPEECH LANGUAGE PATHOLOGIST/OWNER)
(405) 651-4190
Entity
Organization
Contact information
Practice address
2501 SW 93RD ST, OKLAHOMA CITY, OK 73159-6713
(405) 651-1490
(866) 279-0401
Mailing address
2501 SW 93RD ST, OKLAHOMA CITY, OK 73159-6713
(405) 651-1490
(866) 279-0401
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
4014
OK
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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