Provider Demographics
NPI:1265680987
Name:CARTER-FORCINA, GRETA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GRETA
Middle Name:
Last Name:CARTER-FORCINA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:GRETA
Other - Middle Name:C
Other - Last Name:FORCINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:301 S BOULEVARD ST
Mailing Address - Street 2:SUITE 126
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3878
Mailing Address - Country:US
Mailing Address - Phone:405-471-5353
Mailing Address - Fax:405-471-5354
Practice Address - Street 1:301 S BOULEVARD ST
Practice Address - Street 2:SUITE 126
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3878
Practice Address - Country:US
Practice Address - Phone:405-471-5353
Practice Address - Fax:405-471-5354
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK217235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200240970AMedicaid