Individual
MRS. WANDA ANN TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., ED., CCC-SLP
Contact information
Practice address
500 SOUTH ROSS AVE., FORT GIBSON, OK 74434
(918) 348-2181
Mailing address
500 SOUTH AVE, FORT GIBSON, OK 74434
(918) 348-2181
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2584
OK
Other
Enumeration date
10/13/2006
Last updated
08/26/2015
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