Individual
CHARITY STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
Mailing address
902 E LINCOLN RD, IDABEL, OK 74745-7337
(580) 286-2600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF081
OK
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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