Provider Demographics
NPI:1851919799
Name:BIERMAN, THEODORA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:THEODORA
Middle Name:
Last Name:BIERMAN
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 1:1706 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-6110
Mailing Address - Country:US
Mailing Address - Phone:405-219-6824
Mailing Address - Fax:
Practice Address - Street 1:3202 S MEMORIAL DR STE 2
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1323
Practice Address - Country:US
Practice Address - Phone:918-629-5047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist