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

LicenseStateTypeSpecialty
5965OKMDProfessional Counselor
CF418OKMDStudent in an Organized Health Care Education/Training Program

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Jenks, OK

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

Sources for this page

Verify at the official NPI Registry.