Individual
JESSICA DIANE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
14540 S 302ND EAST AVE, COWETA, OK 74429-7845
(918) 486-6506
Mailing address
29833 E 155TH ST S, COWETA, OK 74429-6016
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3131
OK
Other
Enumeration date
11/01/2006
Last updated
08/18/2022
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