Individual
MRS. HEATHER RAYNAE BACKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
211 E 7TH ST, OKMULGEE, OK 74447-4607
(918) 938-0887
Mailing address
388091 E 1134 RD, WELEETKA, OK 74880-9794
(918) 623-6467
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA63
OK
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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