Holly S Bailey, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Jenks, OK
NPI 1467199125 · NPPES record last updated Feb 13, 2024
Key facts
- NPI
- 1467199125
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 5965 (OK)
- Practice address
- 1911 W C St
Jenks, OK 74037-2367 - Phone
- (918) 409-0157
- NPI assigned
- May 15, 2022
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5965 | OK | MD | Professional Counselor |
| CF418 | OK | MD | Student in an Organized Health Care Education/Training Program |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | CF418 | OK | |
| Speech-Language Pathologist | 235Z00000X | 5965 | OK | Yes |
Addresses
Primary practice location
1911 W C St
Jenks, OK 74037-2367
Mailing address
1911 W C St
Jenks, OK 74037-2367
Phone (918) 409-0157
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All providers in Jenks, OK · Speech-Language Pathologist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.