Provider Demographics
NPI:1700227170
Name:WHITEHEAD, MEGAN KATE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KATE
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N GREENWOOD AVE
Mailing Address - Street 2:NORTH HALL 391
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-0702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 N GREENWOOD AVE
Practice Address - Street 2:NORTH HALL 391
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-0702
Practice Address - Country:US
Practice Address - Phone:918-594-8573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist