| Functionality Therapy Services Pllc | |
|
10 W Main St Ste 218a Ardmore OK 73401-6515 | |
| (580) 220-7786 | |
| Not Available |
| Full Name | Functionality Therapy Services Pllc |
|---|---|
| Speciality | Speech-language Pathologist |
| Location | 10 W Main St Ste 218a, Ardmore, Oklahoma |
| Authorized Official Name and Position | Stacey R Ogden (OWNER) |
| Authorized Official Contact | 5802207786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Functionality Therapy Services Pllc 1000 Rockford Ct Ardmore OK 73401-3408 Ph: (580) 220-7786 | Functionality Therapy Services Pllc 10 W Main St Ste 218a Ardmore OK 73401-6515 Ph: (580) 220-7786 |
| NPI Number | 1760919310 |
|---|---|
| Provider Enumeration Date | 05/15/2017 |
| Last Update Date | 05/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760919310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-17-25192 (Oklahoma) | Secondary |
| 235Z00000X | Speech-language Pathologist | 3713 (Oklahoma) | Primary |
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