Provider Demographics
NPI:1295178929
Name:HUMPHREY, JOCELYN JANEA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:JANEA
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:JOCELYN
Other - Middle Name:JANEA
Other - Last Name:ROUNDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:11803 W COOKSEY RD
Mailing Address - Street 2:
Mailing Address - City:CRESCENT
Mailing Address - State:OK
Mailing Address - Zip Code:73028-8774
Mailing Address - Country:US
Mailing Address - Phone:405-757-5851
Mailing Address - Fax:405-260-8820
Practice Address - Street 1:11803 W COOKSEY RD
Practice Address - Street 2:
Practice Address - City:CRESCENT
Practice Address - State:OK
Practice Address - Zip Code:73028-8774
Practice Address - Country:US
Practice Address - Phone:405-757-5851
Practice Address - Fax:405-260-8820
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4180235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist