Organization
ACEBO SPEECH AND LANGUAGE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNETTE R ACEBO MS CCC-SLP (OWNER-SPEECH PATHOLOGIST)
(918) 645-3020
Entity
Organization
Contact information
Practice address
510 N DOUGLAS ST, JENKS, OK 74037-3801
(918) 645-3020
Mailing address
510 N DOUGLAS ST, JENKS, OK 74037-3801
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2910
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000025540A
—
OK
Enumeration date
02/13/2008
Last updated
02/13/2008
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