Provider Demographics
NPI:1194203836
Name:GARRIOTT, GINA CAY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:CAY
Last Name:GARRIOTT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9612 SW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73179-4200
Mailing Address - Country:US
Mailing Address - Phone:405-312-3324
Mailing Address - Fax:
Practice Address - Street 1:9612 SW 35TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73179-4200
Practice Address - Country:US
Practice Address - Phone:405-312-3324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty