Provider Demographics
NPI:1891922407
Name:FUNCTIONAL COMMUNICATION SOLUTIONS, INC.
Entity Type:Organization
Organization Name:FUNCTIONAL COMMUNICATION SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:918-812-5389
Mailing Address - Street 1:2920 E 97TH PL
Mailing Address - Street 2:#2514
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-7437
Mailing Address - Country:US
Mailing Address - Phone:918-812-5389
Mailing Address - Fax:918-254-9107
Practice Address - Street 1:2920 E 97TH PL
Practice Address - Street 2:#2514
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-7437
Practice Address - Country:US
Practice Address - Phone:918-812-5389
Practice Address - Fax:918-254-9107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3016235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty