Provider Demographics
NPI:1801073887
Name:SPEECH/LANGUAGE PATHOLOGY ASSOC. INC.
Entity type:Organization
Organization Name:SPEECH/LANGUAGE PATHOLOGY ASSOC. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STOEVER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:918-585-9994
Mailing Address - Street 1:1617 S CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4203
Mailing Address - Country:US
Mailing Address - Phone:918-585-9994
Mailing Address - Fax:
Practice Address - Street 1:1617 S CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4203
Practice Address - Country:US
Practice Address - Phone:918-585-9994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty