Provider Demographics
NPI:1700570033
Name:SEBA, RUTH E (SLP-CF)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:E
Last Name:SEBA
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FALLVIEW CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-8783
Mailing Address - Country:US
Mailing Address - Phone:405-657-7956
Mailing Address - Fax:
Practice Address - Street 1:1505 RENAISSANCE BLVD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3018
Practice Address - Country:US
Practice Address - Phone:405-850-8497
Practice Address - Fax:405-300-0643
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist