Provider Demographics
NPI:1043635345
Name:SWALLOWING AND NEUROLOGICAL REHABILITATION, LLC
Entity Type:Organization
Organization Name:SWALLOWING AND NEUROLOGICAL REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:SYBILLE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:918-693-8433
Mailing Address - Street 1:2121 S COLUMBIA AVE
Mailing Address - Street 2:SUITE 470
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3518
Mailing Address - Country:US
Mailing Address - Phone:918-928-4700
Mailing Address - Fax:918-928-4701
Practice Address - Street 1:2121 S COLUMBIA AVE
Practice Address - Street 2:SUITE 470
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3518
Practice Address - Country:US
Practice Address - Phone:918-928-4700
Practice Address - Fax:918-928-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-23
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4027261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech