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Individual

MICHAEL WARD HUMPHRIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., CCC-SLP, BCBA

Contact information

Practice address
9031 SW 29TH ST, OKLAHOMA CITY, OK 73179-2818
(405) 464-8484
(405) 883-3061
Mailing address
3812 WEDGEWOOD CREEK DR, OKLAHOMA CITY, OK 73179-1282
(405) 213-5113

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-23-67302
OK
235Z00000X
Speech-Language Pathologist
Primary
4961
OK

Other

Enumeration date
05/16/2018
Last updated
08/22/2024
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