Individual
KAITLYN RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CF-SLP
Contact information
Practice address
240 S ADAMS ST, JENKS, OK 74037-2573
(918) 409-0157
Mailing address
1808 E WINSTON ST, BROKEN ARROW, OK 74011-7507
(918) 616-5852
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF527
OK
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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