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ELITE THERAPY, LLC

Clinical Neuropsychologist

Edmond, Oklahoma

Provider NPI: 1891218202

Organization Information:
Organization Name:  ELITE THERAPY, LLC
Organization is not Subpart
Authorized Official:  SHEA NICOLE PARRY  OWNER/PRESIDENT  405-8508497

Practice Location:
1505 RENAISSANCE BLVD  EDMOND, OK 73013 US
Tel: 405-850-8497  Fax: 405-300-0643

Business Mailing Address:
1505 RENAISSANCE BLVD  EDMOND, OK 73013 US
Tel: 405-850-8497  Fax: 405-300-0643

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
N224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
N225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapist
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
OK2927

Other Provider Identifiers:

IssuerNumberStateType
100649180AOK05
DIANA DORETY MS CCC-SLP104358083001
SHEA PARRY M.ED., M.S. CCC-SLP12040663OK01
JOAN WIGGINS OTR132619443201
SHEA PARRY M.ED., M.S. CCC-SLP136669466301
2004714030AOK05
200006740COK05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS OK - Page 1



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