Provider Demographics
NPI:1245754514
Name:SHARUM, CLAREY REBEKAH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CLAREY
Middle Name:REBEKAH
Last Name:SHARUM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:CLAREY
Other - Middle Name:REBEKAH
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1725 S YORKTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5325
Mailing Address - Country:US
Mailing Address - Phone:417-207-5565
Mailing Address - Fax:
Practice Address - Street 1:9220 HIGHWAY 71 S STE 10
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-9151
Practice Address - Country:US
Practice Address - Phone:479-763-1412
Practice Address - Fax:479-763-1425
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202516235Z00000X
OK1403018235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist