Tyelinda Baumgardner, MS, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Oklahoma City, OK

NPI 1891064259 · NPPES record last updated Dec 14, 2011

Key facts

NPI
1891064259
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3010 (OK)
Practice address
2416 N Ann Arbor Ave
Oklahoma City, OK 73127-1811
Phone
(405) 942-4895
Fax
(405) 942-4895
NPI assigned
Dec 14, 2011
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3010OKMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3010 OK Yes

Addresses

Primary practice location

2416 N Ann Arbor Ave
Oklahoma City, OK 73127-1811

Mailing address

10042 Southridge Dr
Oklahoma City, OK 73159-7329
Phone (405) 613-5367

Other providers in Oklahoma City, OK

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

Sources for this page

Verify at the official NPI Registry.