Provider Demographics
NPI:1912093154
Name:UNIVERSITY OF TULSA/ MARY K CHAPMAN CENTER FOR COMMUNICATIVE DISORDERS
Entity Type:Organization
Organization Name:UNIVERSITY OF TULSA/ MARY K CHAPMAN CENTER FOR COMMUNICATIVE DISORDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVOST/V-P ACADEMIC AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:N
Authorized Official - Last Name:BLAIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-631-3061
Mailing Address - Street 1:600 S COLLEGE AVE
Mailing Address - Street 2:DEPARTMENT OF COMMUNICATION DISORDERS
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-3126
Mailing Address - Country:US
Mailing Address - Phone:918-631-2504
Mailing Address - Fax:918-631-3668
Practice Address - Street 1:600 S COLLEGE AVE
Practice Address - Street 2:DEPARTMENT OF COMMUNICATION DISORDERS
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-3126
Practice Address - Country:US
Practice Address - Phone:918-631-2504
Practice Address - Fax:918-631-3668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty