Provider Demographics
NPI:1245015544
Name:AULD, MOLLY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:AULD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10745 N COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7615
Mailing Address - Country:US
Mailing Address - Phone:214-491-0665
Mailing Address - Fax:
Practice Address - Street 1:10745 N COUNTRY DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-7615
Practice Address - Country:US
Practice Address - Phone:214-491-0665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist