Provider Demographics
NPI:1821330036
Name:EGNOR, KATHRYN KRISTINA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:KRISTINA
Last Name:EGNOR
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 S PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-8501
Mailing Address - Country:US
Mailing Address - Phone:405-612-9011
Mailing Address - Fax:
Practice Address - Street 1:301 S DUCK ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-3249
Practice Address - Country:US
Practice Address - Phone:405-377-8255
Practice Address - Fax:405-835-3920
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3853235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist