Provider Demographics
NPI:1275827768
Name:TIPTON, JANET CAROL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:CAROL
Last Name:TIPTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6802 S OLYMPIA AVE
Mailing Address - Street 2:STE 275
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-1823
Mailing Address - Country:US
Mailing Address - Phone:918-508-7601
Mailing Address - Fax:918-508-7603
Practice Address - Street 1:6802 S OLYMPIA AVE
Practice Address - Street 2:STE 275
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74132-1823
Practice Address - Country:US
Practice Address - Phone:918-508-7601
Practice Address - Fax:918-508-7603
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist