Provider Demographics
NPI:1861642142
Name:SHIPLEY, MARY KATHRYN (AUDIOLOGIST)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:SHIPLEY
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 NW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4463
Mailing Address - Country:US
Mailing Address - Phone:405-946-5563
Mailing Address - Fax:405-945-7185
Practice Address - Street 1:3400 NW 56TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4463
Practice Address - Country:US
Practice Address - Phone:405-946-5563
Practice Address - Fax:405-945-7185
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK185231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist