Provider Demographics
NPI:1356661219
Name:FAITH SLP, INC.
Entity Type:Organization
Organization Name:FAITH SLP, INC.
Other - Org Name:FAITH THERAPY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANNA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:FAITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:918-710-2370
Mailing Address - Street 1:4629 S HARVARD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2948
Mailing Address - Country:US
Mailing Address - Phone:918-710-2370
Mailing Address - Fax:918-398-7983
Practice Address - Street 1:4629 S HARVARD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2948
Practice Address - Country:US
Practice Address - Phone:918-710-2370
Practice Address - Fax:918-398-7983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3503235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty