Individual
MR. MICHAEL BRACKEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS CCC SLP/L
Contact information
Practice address
3017 N STILES AVE STE 200, OKLAHOMA CITY, OK 73105-2805
(405) 271-9477
(405) 271-9479
Mailing address
2305 AUGUSTA DR, MOORE, OK 73160-6261
(405) 437-5048
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1077
OK
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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