Individual
STARLA WITTROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
602 W CHISHOLM DR, KINGFISHER, OK 73750-4348
(405) 375-4194
Mailing address
1540 E BOWMAN AVE, KINGFISHER, OK 73750-3727
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4292
OK
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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