Provider Demographics
NPI:1265273916
Name:AMOS, ABIGAIL ELEASE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ELEASE
Last Name:AMOS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:ABBA
Other - Middle Name:ELEASE
Other - Last Name:AMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:6128 E 38TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6128 E 38TH ST STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5808
Practice Address - Country:US
Practice Address - Phone:918-835-8691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF644235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist