Provider Demographics
NPI:1790036721
Name:BROWN, SHEILA M (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1604 S BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-1614
Mailing Address - Country:US
Mailing Address - Phone:918-629-5400
Mailing Address - Fax:918-757-2338
Practice Address - Street 1:600 N OAK ST
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:OK
Practice Address - Zip Code:74038-5354
Practice Address - Country:US
Practice Address - Phone:918-757-2536
Practice Address - Fax:918-757-2338
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3837235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist