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Individual

MADISON SKYE HUMPHREYS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6905 NW 122ND ST, OKLAHOMA CITY, OK 73142-3903
(405) 603-6622
Mailing address
8321 NW 109TH TER, OKLAHOMA CITY, OK 73162-3012
(405) 802-0732

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
CF-186
OK
235Z00000X
Speech-Language Pathologist
Primary
SP-5556
OK

Other

Enumeration date
01/23/2021
Last updated
06/15/2021
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