Individual
BETHANY ELIZABETH JERAE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
9201 S I 35 SERVICE RD, MOORE, OK 73160-9046
(405) 601-4303
Mailing address
1213 N HARVEY AVE APT 2, OKLAHOMA CITY, OK 73103-3733
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4951
OK
Other
Enumeration date
07/08/2020
Last updated
11/13/2020
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