Individual
STEPHANIE LYNN GANNAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.,CCC-A
Contact information
Practice address
3824 S BOULEVARD STE 110, EDMOND, OK 73013-5779
(405) 562-1810
(405) 562-1816
Mailing address
PO BOX 960472, OKLAHOMA CITY, OK 73196-0472
(405) 755-6651
(405) 755-2795
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
3745
OK
237600000X
Audiologist-Hearing Aid Fitter
Primary
3745
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200338810A
—
OK
Enumeration date
05/24/2011
Last updated
05/15/2023
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