Provider Demographics
NPI:1407036577
Name:ESKEW, MICHELLE D (SLP, CCC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
Last Name:ESKEW
Suffix:
Gender:F
Credentials:SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 NW 47TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-6400
Mailing Address - Country:US
Mailing Address - Phone:405-606-2007
Mailing Address - Fax:405-606-2008
Practice Address - Street 1:1024 NW 47TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-6400
Practice Address - Country:US
Practice Address - Phone:405-606-2007
Practice Address - Fax:405-606-2008
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK560235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist