Cicely Fanning

NPI 1043304132 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1043304132
Gender Female
Enumeration Date 10/03/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2208 N YELLOWOOD AVE
BROKEN ARROW OK, 74012-9102, US
Phone (918) 286-1261
Fax
Business Location
2208 N YELLOWOOD AVE
BROKEN ARROW OK, 74012-9102, US
Phone (918) 286-1261
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Oklahoma
License Number 12094555
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According to our database, Cicely Fanning NPI is 1043304132, taxonomy code is 235Z00000X and license number is 12094555, license state is located at Oklahoma. Cicely Fanning physically located at 2208 N Yellowood Ave, Broken Arrow OK, 74012-9102. NPI Number Cicely Fanning has the Individual type.

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1043304132 NPI number is provided on an as is basis without warranty of any kind. 1043304132 is maintained by the National Plan & Provider Enumeration System. The contents of Cicely Fanning are for informational purposes only.