Heather Raynae Backus, SLPA
Individual provider Active NPI Speech-Language Assistant · Okmulgee, OK
NPI 1679248207 · NPPES record last updated Aug 16, 2021
Key facts
- NPI
- 1679248207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Assistant 2355S0801X
- License
- SLPA63 (OK)
- Practice address
- 211 E 7TH St
Okmulgee, OK 74447-4607 - Phone
- (918) 938-0887
- NPI assigned
- Aug 16, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| SLPA63 | OK | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wonderfully Made Therapy Group, LLC | Current |
Accepting new patients |
Locations
211 E 7th St
Okmulgee, OK 74447
Phone (918) 809-0101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SLPA63 | OK | Yes |
Addresses
Primary practice location
211 E 7TH St
Okmulgee, OK 74447-4607
Mailing address
388091 E 1134 Rd
Weleetka, OK 74880-9794
Phone (918) 623-6467
Other providers in Okmulgee, OK
- Stephanie Michelle Anderson
- Linda Susan Aranaydo
- Kelsey N Ashley
- Rachel Kate Austin
- Jennifer Avery
- Taquia Bagby
- Becky Ledon Baker
- H Gary Baker
- Allison Victoria Barnes
- Melissa Barnett
All providers in Okmulgee, OK · Speech-Language Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2021. 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.