Individual
MRS. DANA LEA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
940413 S 3330 RD, WELLSTON, OK 74881-7075
(405) 503-5148
Mailing address
940413 S 3330 RD, WELLSTON, OK 74881-7075
(405) 503-5148
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4393
OK
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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