Provider Demographics
NPI:1598335093
Name:HARRELL, SAVANNAH GAIL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:GAIL
Last Name:HARRELL
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 1:1816 S CARSON AVE APT 130
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-5032
Mailing Address - Country:US
Mailing Address - Phone:918-694-8717
Mailing Address - Fax:
Practice Address - Street 1:3838 STATE ST
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2528
Practice Address - Country:US
Practice Address - Phone:918-694-8717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5606235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist