Sharon Mills

Individual provider Active NPI Speech-Language Pathologist · Keota, OK

NPI 1104293539 · NPPES record last updated Sep 2, 2015

Key facts

NPI
1104293539
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2638 (OK)
Practice address
510 E 7TH St
Keota, OK 74941-6788
Phone
(918) 448-4540
NPI assigned
Sep 2, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2638OKMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2638 OK Yes

Addresses

Primary practice location

510 E 7TH St
Keota, OK 74941-6788

Mailing address

510 E 7TH St
Keota, OK 74941-6788

Other providers in Keota, OK

All providers in Keota, OK · Speech-Language Pathologist in Oklahoma

Sources for this page

Verify at the official NPI Registry.