Provider Demographics
NPI:1821615097
Name:CASH, CHARLA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:
Last Name:CASH
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 1:1713 REGENCY CT
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-8406
Mailing Address - Country:US
Mailing Address - Phone:303-229-3562
Mailing Address - Fax:
Practice Address - Street 1:326 N UNION AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-7053
Practice Address - Country:US
Practice Address - Phone:303-229-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK139123235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist