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Individual

KAIDEN LEIGH FATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
4517 S YELLOW PINE AVE, BROKEN ARROW, OK 74011-5616
(918) 728-4121
Mailing address
10909 S 87TH EAST AVE, TULSA, OK 74133-7223
(918) 728-4121

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
05/27/2021
Last updated
06/19/2024
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