| Doctor Name: | MINDY DAWN PHAM |
| NPI Number: | 1649377292 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 2631 |
| Business Practice Address: | 8827 E Reno Ave Suite 201 Midwest City, OK - 731107732 |
| Business Phone Number: | 4056103048 |
| Business Fax Number: | 4056103049 |
| Mailing Address: | 3360 N Ave Bldg 685, TINKER AFB |
| State: | OK |
| Postal Code: | 731459028 |
| Phone Number: | 4054552587 |
| Fax Number: | 4057333124 |
| NPI Enumeration Date: | 09/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2631 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |