Provider Demographics
NPI:1972270924
Name:TRZECKI, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:TRZECKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 S RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-6127
Mailing Address - Country:US
Mailing Address - Phone:918-408-8031
Mailing Address - Fax:
Practice Address - Street 1:4157 S HARVARD AVE STE 117
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2606
Practice Address - Country:US
Practice Address - Phone:918-712-7868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist