Provider Demographics
NPI:1093012411
Name:NAUGHER, AMY ELLIS (MS CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:ELLIS
Last Name:NAUGHER
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:ELLIS
Other - Last Name:PELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ST
Mailing Address - Street 1:10045 S LAKEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-5530
Mailing Address - Country:US
Mailing Address - Phone:903-744-3374
Mailing Address - Fax:
Practice Address - Street 1:10045 S LAKEWOOD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-5530
Practice Address - Country:US
Practice Address - Phone:903-744-3374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3560235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist