Provider Demographics
NPI:1326584855
Name:SIMS, HALEY (CCTV-SLP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:CCTV-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15901 E LATIMER PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74116-2837
Mailing Address - Country:US
Mailing Address - Phone:214-264-9210
Mailing Address - Fax:
Practice Address - Street 1:4300 W HOUSTON ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4519
Practice Address - Country:US
Practice Address - Phone:918-254-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-08
Last Update Date:2017-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist