Provider Demographics
NPI:1174933345
Name:LE, THAO THAO THUONG (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:THAO
Middle Name:THAO THUONG
Last Name:LE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:THAO THUONG
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:2002 E ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-7420
Mailing Address - Country:US
Mailing Address - Phone:405-307-2849
Mailing Address - Fax:405-307-2801
Practice Address - Street 1:2002 E ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-7420
Practice Address - Country:US
Practice Address - Phone:405-307-2849
Practice Address - Fax:405-307-2801
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist