Individual
MRS. TONYA ANN BUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP SPEECH PA
Contact information
Practice address
127 STEVEN DRIVE, SHAWNEE, OK 74804-6307
(405) 401-0606
Mailing address
127 STEVEN DRIVE, SHAWNEE, OK 74804-6307
(405) 214-6526
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2637
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12005431
ASHA
—
Enumeration date
11/29/2006
Last updated
07/08/2007
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