Provider Demographics
NPI:1992194534
Name:GARRETT SPEECH LANGUAGE PATHOLOGY
Entity Type:Organization
Organization Name:GARRETT SPEECH LANGUAGE PATHOLOGY
Other - Org Name:THE SPEECHFUL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LEANN
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:405-412-1003
Mailing Address - Street 1:2713 SW 140TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5781
Mailing Address - Country:US
Mailing Address - Phone:405-412-1003
Mailing Address - Fax:
Practice Address - Street 1:2713 SW 140TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5781
Practice Address - Country:US
Practice Address - Phone:405-412-1003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3211261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech