Provider Demographics
NPI:1861170441
Name:PATTERSON, NIKKI DANIELLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:DANIELLE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:DANIELLE
Other - Last Name:HAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:NE 4TH & MAIN
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:OK
Mailing Address - Zip Code:73439
Mailing Address - Country:US
Mailing Address - Phone:580-564-2993
Mailing Address - Fax:
Practice Address - Street 1:NE 4TH & MAIN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:OK
Practice Address - Zip Code:73439
Practice Address - Country:US
Practice Address - Phone:580-564-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist