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120 S Lester Lane, Purcell, OK 73080-5451 | |
| (405) 766-1238 | |
| (405) 310-0679 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Hearing And Speech |
| Location | 120 S Lester Lane, Purcell, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043854706 | NPI | - | NPPES |
| 14002787 | Other | ASHA | |
| 19013 | Other | CA | CALIFORNIA STATE LICENSE |
| 200952980A | Medicaid | OK | |
| 4171 | Other | OK | OKLAHOMA SLP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 261QH0700X | Clinic/center - Hearing And Speech | (* (Not Available)) | Primary |
| Provider Name | Kristina A Freeborn |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871915462 PECOS PAC ID: 7719283985 Enrollment ID: I20160315000406 |
| Provider Name | Cassia May Claunch |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649753971 PECOS PAC ID: 2062808108 Enrollment ID: I20220330000109 |
| Provider Name | Alesa Deon Mcphail |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1265952147 PECOS PAC ID: 1355883703 Enrollment ID: I20240612004551 |
| Mailing Address | Practice Location Address |
|---|---|
18550 144th St, Lexington, OK 73051-6803 Ph: (405) 766-1238 | 120 S Lester Lane, Purcell, OK 73080-5451 Ph: (405) 766-1238 |