Individual
MR. DENNIS MAMMEN MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS CCC-SLP
Contact information
Practice address
9316 SW 23RD ST, OKLAHOMA CITY, OK 73128-1839
(405) 249-9646
Mailing address
9316 SW 23RD ST, OKLAHOMA CITY, OK 73128-1839
(405) 249-9646
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3452
OK
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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