Provider Demographics
NPI:1649372863
Name:HORN, MONA DEFELICE (SPEECH PATH)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:DEFELICE
Last Name:HORN
Suffix:
Gender:F
Credentials:SPEECH PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017
Mailing Address - Country:US
Mailing Address - Phone:918-342-3800
Mailing Address - Fax:918-342-3900
Practice Address - Street 1:1810 N SIOUX ST
Practice Address - Street 2:STE C
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017
Practice Address - Country:US
Practice Address - Phone:918-342-3800
Practice Address - Fax:918-342-3900
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2018-10-03
Deactivation Date:2018-08-30
Deactivation Code:
Reactivation Date:2018-10-03
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program