Individual
MRS. STACY MICHELE PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
7787 S 425 RD, INOLA, OK 74036-5364
(918) 691-8157
Mailing address
7787 S 425 RD, INOLA, OK 74036-5364
(918) 691-8157
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4327
OK
Other
Enumeration date
08/09/2007
Last updated
06/12/2019
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