Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Nicki Jo Theodoridis, MED, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1932653789

Mrs. Nicki Jo Theodoridis, MED, CCC-SLP is a Speech-Language Pathologist in Edmond, Oklahoma. Practices as a sole proprietor. Licensed in Kansas, Missouri and Oklahoma.

Licensed in
KS, MO, OK
In the registry since
2016
Specialties on file
3
What do these letters mean?
MED — Master of Education
A graduate education degree, written M.Ed.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

715 Glenridge Dr
Edmond, OK 73013-1824
Phone: (816) 753-5459
Fax: (816) 753-5119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 996 (OK)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 2016009648 (MO)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 3903 (KS)

Record details

NPI number1932653789
Entity typeIndividual (Type 1)
GenderFemale
Credentials MED , CCC-SLP
Sole proprietorYes
NPI enumeratedAugust 10, 2016
Last updated in NPPESAugust 10, 2016

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