Provider Demographics
NPI:1376165019
Name:STANTON, SHYLA MYRAN (MS, SLP-CF)
Entity Type:Individual
Prefix:
First Name:SHYLA
Middle Name:MYRAN
Last Name:STANTON
Suffix:
Gender:F
Credentials:MS, SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 LYNWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-8604
Mailing Address - Country:US
Mailing Address - Phone:918-520-8495
Mailing Address - Fax:
Practice Address - Street 1:5840 S MEMORIAL DR STE 302
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9037
Practice Address - Country:US
Practice Address - Phone:918-699-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-15
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF528235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist