Debra A Secrest, MS CCCSLP
Individual provider Active NPI Speech-Language Pathologist · Normau, OK
NPI 1750468757 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1750468757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2005 (OK)
- Practice address
- 2002 E Robinson
Normau, OK 73071 - Phone
- (405) 307-2814
- Fax
- (405) 307-2814
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005 | OK | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2005 | OK | Yes |
Addresses
Primary practice location
2002 E Robinson
Normau, OK 73071
Mailing address
PO Box 490
Normau, OK 73070
Phone (405) 307-2800
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.