Individual
MRS. LISA L. IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD., CCC-A
Contact information
Practice address
432 S MUSTANG RD, SUITE B, YUKON, OK 73099-7312
(405) 265-1133
(405) 265-1144
Mailing address
3700 E 32ND ST, EDMOND, OK 73013-7926
(405) 471-5722
(405) 265-1144
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
280
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200105800A
—
OK
Enumeration date
02/13/2007
Last updated
04/20/2011
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