Individual
MONICA DAWN JUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S CCC-SLP
Contact information
Practice address
2208 W DETROIT ST STE 101, BROKEN ARROW, OK 74012-3630
(918) 806-0106
(918) 806-0113
Mailing address
24935 KY AVE, CLAREMORE, OK 74019-4348
(918) 706-4140
(918) 343-9469
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3116
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049340A
—
OK
Enumeration date
08/06/2007
Last updated
01/07/2010
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