Functionality Therapy Services PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3713 Issued in OK

Legal business name

FUNCTIONALITY THERAPY SERVICES PLLC

Practice address

10 W Main St Ste 218a
Ardmore, OK 73401-6515

Phone

(580) 220-7786

NPI assigned

May 15, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Stacey R Ogden, M.A. CCC-SLP

Title

Owner

Phone

(580) 220-7786

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494806400000",
    "number": "1760919310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ROCKFORD CT",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734013408",
            "telephone_number": "580-220-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W MAIN ST STE 218A",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734016515",
            "telephone_number": "580-220-7786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONALITY THERAPY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-15",
        "last_updated": "2017-05-15",
        "status": "A",
        "authorized_official_last_name": "OGDEN",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-220-7786",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "1-17-25192",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Suzanne Frock, RN
• Andrea Fuentes
• Gwen Canarias Fuentes, M.D.
• Jo L Fuller, APRN-CNP
• Stephanie Celeste Fulmer
• Fundamentals Therapy Clinic
• Stephanie Kay Furrh
• Tony Simon Germans Gabriel, M.D
• Bryce Gaddy
• Sierra Lorene Gaines

• Speech-Language Pathologist in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.