Individual
MRS. ANDREA MICHAEL LEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP/L
Contact information
Practice address
9630 S SANDUSKY AVE, TULSA, OK 74137-4811
(918) 269-6270
Mailing address
9630 S SANDUSKY AVE, TULSA, OK 74137-4811
(918) 269-6270
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4008
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200471500A
—
OK
Enumeration date
01/30/2013
Last updated
06/04/2013
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