Organization
ELITE THERAPY, LLC
Active
Other names
Elite Therapy Associates
Organization subpart
No
Provider details
NPI number
Authorized official
SHEA NICOLE PARRY M.ED., M.S. CCC-SLP (OWNER/PRESIDENT)
(405) 850-8497
Entity
Organization
Contact information
Practice address
1505 RENAISSANCE BLVD, EDMOND, OK 73013-3018
(405) 850-8497
(405) 300-0643
Mailing address
1505 RENAISSANCE BLVD, EDMOND, OK 73013-3018
(405) 850-8497
(405) 300-0643
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
2927
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100649180A
—
OK
01
—
1043580830
DIANA DORETY MS CCC-SLP
—
01
—
12040663
SHEA PARRY M.ED., M.S. CCC-SLP
OK
01
—
1326194432
JOAN WIGGINS OTR
—
01
—
1366694663
SHEA PARRY M.ED., M.S. CCC-SLP
—
05
—
200006740C
—
OK
05
—
2004714030A
—
OK
Enumeration date
07/18/2017
Last updated
08/08/2017
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