Individual
MRS. JANE SUSAN DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED. C.C.C.-SLP
Contact information
Practice address
2121 N AIR DEPOT BLVD, EDMOND, OK 73034-7625
(405) 340-1534
Mailing address
2121 N AIR DEPOT BLVD, EDMOND, OK 73034-7625
(405) 340-1534
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
657
OK
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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