Individual
JESSICA BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
308 NE 2ND ST, WAGONER, OK 74467-4441
(918) 485-3692
Mailing address
308 NE 2ND ST, WAGONER, OK 74467-4441
(918) 485-3692
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3512
OK
Other
Enumeration date
05/27/2015
Last updated
05/11/2017
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