Wanda Ann Teague, M.S., ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2584 Issued in OK

Practice address

500 South Ross Ave.
Fort Gibson, OK 74434

Phone

(918) 348-2181

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1982794442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SOUTH AVE",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "74434",
            "telephone_number": "918-348-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SOUTH ROSS AVE.",
            "city": "FORT GIBSON",
            "state": "OK",
            "postal_code": "74434",
            "telephone_number": "918-348-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "WANDA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S., ED., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scotts Pharmacy LLC (Valu-Med Pharmacy)
• James Mark Seabolt
• Taldg PLLC (Ft. Gibson Family Dentistry)
• Mindy E Taylor-Culver, LPC
• Heather Raye Taylor
• The Therapy House
• Carlene Toney, PTA
• Walker & Walker P.L.L.C. (Ft. Gibson Family Dentistry)
• Andrew L Walker, DDS
• Michelle Wallace

• Speech-Language Pathologist in Fort Gibson, OK
• Providers in Fort Gibson, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.