Provider Demographics
NPI:1629316153
Name:IRVING, VASHNI
Entity Type:Individual
Prefix:
First Name:VASHNI
Middle Name:
Last Name:IRVING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:OK
Mailing Address - Zip Code:73728-3832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:OK
Practice Address - Zip Code:73728-3832
Practice Address - Country:US
Practice Address - Phone:580-596-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist