Provider Demographics
NPI:1740429562
Name:SPLENDID SPEECH
Entity Type:Organization
Organization Name:SPLENDID SPEECH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCCSLP
Authorized Official - Phone:405-819-4932
Mailing Address - Street 1:32 HAZYBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-7804
Mailing Address - Country:US
Mailing Address - Phone:405-819-4932
Mailing Address - Fax:405-224-6411
Practice Address - Street 1:32 HAZYBROOK CIR
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-7804
Practice Address - Country:US
Practice Address - Phone:405-819-4932
Practice Address - Fax:405-224-6411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2113235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty