Provider Demographics
NPI:1275872582
Name:POLLARD, MALINDA GAIL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MALINDA
Middle Name:GAIL
Last Name:POLLARD
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:HC 63 BOX 350
Mailing Address - Street 2:
Mailing Address - City:FT TOWSON
Mailing Address - State:OK
Mailing Address - Zip Code:74735-9245
Mailing Address - Country:US
Mailing Address - Phone:580-317-4280
Mailing Address - Fax:
Practice Address - Street 1:410 N M ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-1820
Practice Address - Country:US
Practice Address - Phone:580-326-7561
Practice Address - Fax:580-326-4957
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3932235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist