Provider Demographics
NPI:1780281196
Name:SHAYE SPEECH THERAPY
Entity type:Organization
Organization Name:SHAYE SPEECH THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAYE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-900-4123
Mailing Address - Street 1:11912 S NANDINA ST
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-4375
Mailing Address - Country:US
Mailing Address - Phone:918-900-4123
Mailing Address - Fax:
Practice Address - Street 1:11912 S NANDINA ST
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-4375
Practice Address - Country:US
Practice Address - Phone:918-900-4123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty