Individual
MAKENZY MICHELLE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11216 NW 112TH ST, YUKON, OK 73099-8033
(405) 343-0034
Mailing address
11216 NW 112TH ST, YUKON, OK 73099-8033
(405) 343-0034
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5325
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
OK
Enumeration date
07/05/2022
Last updated
07/05/2022
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