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Organization

NORTHEASTERN SPEECH THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHELSEA RENEE POTEETE M.A., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(918) 931-8941
Entity
Organization

Contact information

Practice address
18771 S 525 RD, TAHLEQUAH, OK 74464-0518
(918) 931-8941
Mailing address
PO BOX 1612, TAHLEQUAH, OK 74465-1612
(918) 931-8941

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3626
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200285740
OK
Enumeration date
06/22/2012
Last updated
06/22/2012
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