Individual
AVERY STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PROGRAM DIRECTOR SLP
Contact information
Practice address
6800 S GRANITE AVE, TULSA, OK 74136-7039
(918) 822-2554
Mailing address
10619 S NATHAN ST, JENKS, OK 74037-1821
(918) 822-2554
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4542
OK
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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