Provider Demographics
NPI:1659519262
Name:SADLER, MARY (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:SADLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-2905
Mailing Address - Country:US
Mailing Address - Phone:918-747-2899
Mailing Address - Fax:918-747-8426
Practice Address - Street 1:2145 E 23RD ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-2905
Practice Address - Country:US
Practice Address - Phone:918-747-2899
Practice Address - Fax:918-747-8426
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK777235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist