Provider Demographics
NPI:1992361711
Name:RAMEY, TINA
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:RAMEY
Suffix:
Gender:F
Credentials:
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 119
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:OK
Mailing Address - Zip Code:74852-0119
Mailing Address - Country:US
Mailing Address - Phone:405-598-8889
Mailing Address - Fax:
Practice Address - Street 1:1318 E INDEPENDENCE ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-4137
Practice Address - Country:US
Practice Address - Phone:405-275-1801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist