Provider Demographics
NPI:1508404294
Name:MITCHELL, PAULA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 INDIAN POINT CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-8634
Mailing Address - Country:US
Mailing Address - Phone:918-852-7208
Mailing Address - Fax:
Practice Address - Street 1:2429 WESTPORT DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6337
Practice Address - Country:US
Practice Address - Phone:405-308-9120
Practice Address - Fax:405-928-5530
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist