Provider Demographics
NPI:1467702605
Name:HARRIS-SILK, MALINDA VINEYARD (MSCCC-SP)
Entity Type:Individual
Prefix:MS
First Name:MALINDA
Middle Name:VINEYARD
Last Name:HARRIS-SILK
Suffix:
Gender:F
Credentials:MSCCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13905 PLYMOUTH XING
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-7037
Mailing Address - Country:US
Mailing Address - Phone:405-388-8787
Mailing Address - Fax:
Practice Address - Street 1:3030 NW EXPRESSWAY #809
Practice Address - Street 2:
Practice Address - City:OKC
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-917-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2215235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist