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Individual

SUSAN DOWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
1019 CHUCKWA DR, DURANT, OK 74701-2623
(580) 924-8579
(580) 745-9357
Mailing address
85 TIMOTHY LN, CALERA, OK 74730-5122
(918) 306-2123

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4382
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14041593
ASHA LICENSE FOR CLINICAL COMPETENCE IN SPEECH-LANGUAGE PATHOLOGY
OK
01
4382
OKLAHOMA STATE LICENSE FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
OK
Enumeration date
08/25/2015
Last updated
08/25/2015
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