Provider Demographics
NPI:1679099345
Name:WAY, KASEE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KASEE
Middle Name:
Last Name:WAY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MISS
Other - First Name:KASEE
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:8822 S 70TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5059
Mailing Address - Country:US
Mailing Address - Phone:405-973-4614
Mailing Address - Fax:
Practice Address - Street 1:109 N ARMSTRONG ST
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-4449
Practice Address - Country:US
Practice Address - Phone:918-336-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14131433235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist