Provider Demographics
NPI:1699590950
Name:LENIHAN, MARY (MS , CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:LENIHAN
Suffix:
Gender:F
Credentials:MS , CCC-SLP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:CLANCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:200 S ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-8727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 S ACADEMY RD
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-8727
Practice Address - Country:US
Practice Address - Phone:405-282-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist