Provider Demographics
NPI:1134796386
Name:GRAY, SHERIDAN ANN (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:SHERIDAN
Middle Name:ANN
Last Name:GRAY
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 GOLF COURSE DR
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-4215
Mailing Address - Country:US
Mailing Address - Phone:405-609-7124
Mailing Address - Fax:
Practice Address - Street 1:429 W WILSHIRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7745
Practice Address - Country:US
Practice Address - Phone:405-250-3071
Practice Address - Fax:405-849-5260
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF344235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist