Provider Demographics
NPI:1316140973
Name:PATTON, LYN (MED, CCC)
Entity type:Individual
Prefix:MRS
First Name:LYN
Middle Name:
Last Name:PATTON
Suffix:
Gender:F
Credentials:MED, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 S BROADWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4038
Mailing Address - Country:US
Mailing Address - Phone:405-340-7056
Mailing Address - Fax:
Practice Address - Street 1:2500 S BROADWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4038
Practice Address - Country:US
Practice Address - Phone:405-340-7056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2567235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist