Provider Demographics
NPI:1255690426
Name:OAKES, STACI STALLINGS (MS)
Entity Type:Individual
Prefix:MRS
First Name:STACI
Middle Name:STALLINGS
Last Name:OAKES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 W WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-1876
Mailing Address - Country:US
Mailing Address - Phone:405-285-5992
Mailing Address - Fax:
Practice Address - Street 1:1924 W WATERLOO RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73025-2777
Practice Address - Country:US
Practice Address - Phone:405-285-5992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3891235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist