Provider Demographics
NPI:1093227787
Name:DANSER, AUBREY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:DANSER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:MACKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CF-SLP
Mailing Address - Street 1:4900 S BLACK RD
Mailing Address - Street 2:
Mailing Address - City:COLEMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73432-8817
Mailing Address - Country:US
Mailing Address - Phone:580-916-6202
Mailing Address - Fax:
Practice Address - Street 1:2429 WESTPORT DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069
Practice Address - Country:US
Practice Address - Phone:405-308-9120
Practice Address - Fax:405-928-5530
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4860235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist