Provider Demographics
NPI:1265952147
Name:MCPHAIL, ALESA DEON (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:ALESA
Middle Name:DEON
Last Name:MCPHAIL
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 MARILYN DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-0624
Mailing Address - Country:US
Mailing Address - Phone:405-650-9022
Mailing Address - Fax:
Practice Address - Street 1:120 SOUTH LESTER LN
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-5451
Practice Address - Country:US
Practice Address - Phone:405-766-1238
Practice Address - Fax:405-310-0679
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4544235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist