Provider Demographics
NPI:1235316472
Name:CHRISTOPHER, ALICIA A (SLP)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:A
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E B ST
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-3906
Mailing Address - Country:US
Mailing Address - Phone:918-299-4415
Mailing Address - Fax:
Practice Address - Street 1:205 E B ST
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-3906
Practice Address - Country:US
Practice Address - Phone:918-299-4415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3374235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist