Provider Demographics
NPI:1568052652
Name:WATSON, SHALYNN ANNET (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:SHALYNN
Middle Name:ANNET
Last Name:WATSON
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:SHALYNN
Other - Middle Name:
Other - Last Name:FLANAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1831 AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-2640
Mailing Address - Country:US
Mailing Address - Phone:405-273-3388
Mailing Address - Fax:
Practice Address - Street 1:1831 AIRPORT DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-2640
Practice Address - Country:US
Practice Address - Phone:405-273-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKSLPA1822355S0801X
OK391235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant