Tabetha Nicole Mathiesen MS CCC-SLP

NPI 1093065682 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1093065682
Gender Female
Enumeration Date 09/11/2012
Last Updated 07/11/2013
Entity Type Individual
Active Over 4 years ago
Practice Location
205 E CIMARRON BLVD
CRESCENT OK, 73028-9296, US
Phone (405) 795-7110
Fax
Business Location
205 E CIMARRON BLVD
CRESCENT OK, 73028-9296, US
Phone (405) 795-7110
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Oklahoma
License Number 3775
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According to our database, Mrs. Tabetha Nicole Mathiesen MS CCC-SLP NPI is 1093065682, taxonomy code is 235Z00000X and license number is 3775, license state is located at Oklahoma. Tabetha Nicole Mathiesen MS CCC-SLP physically located at 205 E Cimarron Blvd, Crescent OK, 73028-9296. NPI Number Tabetha Nicole Mathiesen MS CCC-SLP has the Individual type.

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1093065682 NPI number is provided on an as is basis without warranty of any kind. 1093065682 is maintained by the National Plan & Provider Enumeration System. The contents of Tabetha Nicole Mathiesen MS CCC-SLP are for informational purposes only.