Provider Demographics
NPI:1356673180
Name:RICE, TRESSA FERN (MS CCC SLP)
Entity type:Individual
Prefix:MISS
First Name:TRESSA
Middle Name:FERN
Last Name:RICE
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:510 S ELLIOTT ST STE C
Mailing Address - Street 2:MAYES COUNTY SPEECH THERAPY
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-6429
Mailing Address - Country:US
Mailing Address - Phone:918-633-9173
Mailing Address - Fax:
Practice Address - Street 1:510 S. ELLIOTT ST. SUITE C
Practice Address - Street 2:MAYES COUNTY SPEECH THERAPY
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361
Practice Address - Country:US
Practice Address - Phone:918-825-4837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4630OtherOBESPA
14113542OtherASHA