Individual
MRS. LISA G VANWIEREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
3000 UNITED FOUNDERS BLVD STE 113G, OKLAHOMA CITY, OK 73112-3931
(405) 840-1335
(405) 840-1336
Mailing address
3000 UNITED FOUNDERS BLVD STE 113G, OKLAHOMA CITY, OK 73112-3931
(405) 840-1335
(405) 840-1336
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
2084
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100656080C
—
OK
Enumeration date
08/11/2006
Last updated
12/03/2024
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