Individual
RILEY LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7707 W BRITTON RD, OKLAHOMA CITY, OK 73132-1512
(405) 720-7200
Mailing address
2100 W BEAVER POINT DR, MUSTANG, OK 73064-6442
(405) 919-5978
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF699
OK
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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