Provider Demographics
NPI:1881458511
Name:TURNER, AMANDA LEE-WRAY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE-WRAY
Last Name:TURNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CHATEAU BND
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-6548
Mailing Address - Country:US
Mailing Address - Phone:580-220-4298
Mailing Address - Fax:
Practice Address - Street 1:120 S LESTER LANE
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-5451
Practice Address - Country:US
Practice Address - Phone:405-766-1238
Practice Address - Fax:405-310-0679
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4768235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty