Individual
MIKLYNNE EMMY EASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
510 E COMANCHE ST, JENKS, OK 74037-4522
(918) 852-4227
Mailing address
510 E COMANCHE ST, JENKS, OK 74037-4522
(918) 852-4227
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14338680
OK
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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