Provider Demographics
NPI:1891190823
Name:MIGGLETTO, APRIL DAWN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:DAWN
Last Name:MIGGLETTO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2038
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74465-2038
Mailing Address - Country:US
Mailing Address - Phone:918-316-1172
Mailing Address - Fax:918-456-0978
Practice Address - Street 1:19061 E 840 RD
Practice Address - Street 2:
Practice Address - City:PARK HILL
Practice Address - State:OK
Practice Address - Zip Code:74451-4105
Practice Address - Country:US
Practice Address - Phone:918-456-4501
Practice Address - Fax:918-456-7559
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3052235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist