Individual
MRS. BROOKE PREGLER KLINTWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
12428 S 4TH ST, JENKS, OK 74037-1077
(918) 809-0300
Mailing address
PO BOX 1336, JENKS, OK 74037-1336
(918) 809-0300
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2771
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200045120A
—
OK
Enumeration date
01/22/2009
Last updated
01/22/2009
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