Provider Demographics
NPI:1417920935
Name:BARGER-FENTON, CYNTHIA A (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:A
Last Name:BARGER-FENTON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:B
Other - Last Name:FENTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:4200 CHERRYSTONE RD
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-5962
Mailing Address - Country:US
Mailing Address - Phone:405-391-7568
Mailing Address - Fax:405-391-6035
Practice Address - Street 1:5509 MAIN STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115
Practice Address - Country:US
Practice Address - Phone:405-245-7376
Practice Address - Fax:405-391-6035
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK841235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100639720CMedicaid
OK100639720AMedicaid