Organization
TIFFANY KEITZ SPEECH PATHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY KEITZ MS CCC SLP (OWNER/THERAPIST)
(580) 231-8081
Entity
Organization
Contact information
Practice address
2615 E RANDOLPH, STE 112, ENID, OK 73701-4670
(580) 231-8081
(580) 234-2615
Mailing address
2615 E RANDOLPH, STE 112, ENID, OK 73701-4670
(580) 231-8081
(580) 234-2615
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
3182
OK
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200125650B
—
OK
05
—
200545210A
—
OK
Enumeration date
07/30/2014
Last updated
05/12/2020
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