Provider Demographics
NPI:1295228500
Name:DRISKELL, ANDREA M (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:DRISKELL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:M
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 SE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-5529
Mailing Address - Country:US
Mailing Address - Phone:405-779-3270
Mailing Address - Fax:
Practice Address - Street 1:400 SE 2ND ST
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-5529
Practice Address - Country:US
Practice Address - Phone:405-779-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty