Provider Demographics
NPI:1770728446
Name:THE SCHOLL CENTER FOR COMMUNICATION DISORDERS
Entity type:Organization
Organization Name:THE SCHOLL CENTER FOR COMMUNICATION DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:ROGERS
Authorized Official - Last Name:SCHOLL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:918-508-7601
Mailing Address - Street 1:PO BOX 21228 DEPT 13
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74121-1228
Mailing Address - Country:US
Mailing Address - Phone:918-508-7601
Mailing Address - Fax:918-508-7602
Practice Address - Street 1:4415 S HARVARD AVE STE 125
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-9700
Practice Address - Country:US
Practice Address - Phone:918-508-7601
Practice Address - Fax:918-508-7603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK278231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5414OtherMEDICARE PTAN