Organization
PEDIATRIC PATHWAYS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRA DERR MS, CCC-SLP (OWNER/SLP)
(405) 213-3324
Entity
Organization
Contact information
Practice address
111 N 5TH ST STE 10, CHICKASHA, OK 73018-2405
(405) 213-3324
Mailing address
209 PLEASANT LN, CHICKASHA, OK 73018-7727
(405) 213-3324
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
12/12/2024
Last updated
12/13/2024
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