Provider Demographics
NPI:1649753971
Name:CLAUNCH, CASSIA MAY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASSIA
Middle Name:MAY
Last Name:CLAUNCH
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20825 250TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73093-4604
Mailing Address - Country:US
Mailing Address - Phone:405-569-2915
Mailing Address - Fax:
Practice Address - Street 1:14901 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6069
Practice Address - Country:US
Practice Address - Phone:405-752-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4572235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist