Individual
MISS JENNA MARIE SMALLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
HC 66 BOX 765, SAWYER, OK 74756-9768
(580) 298-7314
Mailing address
HC 66 BOX 765, SAWYER, OK 74756-9768
(580) 298-7314
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
12153844
—
235Z00000X
Speech-Language Pathologist
Primary
3638
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12153844
ASHA
—
01
—
3638
OBESPA
OK
Enumeration date
08/14/2012
Last updated
08/14/2012
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