Provider Demographics
NPI:1154824571
Name:OKLAHOMA SPEECH & LANGUAGE THERAPY, LLC
Entity Type:Organization
Organization Name:OKLAHOMA SPEECH & LANGUAGE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:918-231-0224
Mailing Address - Street 1:8771 S 261ST EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-3276
Mailing Address - Country:US
Mailing Address - Phone:918-231-0224
Mailing Address - Fax:918-872-7116
Practice Address - Street 1:8771 S 261ST EAST AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-3276
Practice Address - Country:US
Practice Address - Phone:918-231-0224
Practice Address - Fax:918-872-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3439235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty