Individual
MARIANNE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
400 S ANDERSON RD, CHOCTAW, OK 73020-7207
(216) 501-2551
Mailing address
400 S ANDERSON RD, CHOCTAW, OK 73020-7207
(216) 501-2551
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5211
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
12/13/2019
Last updated
06/22/2021
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