Doctor Name: | SHAWN PRESLEY |
NPI Number: | 1962878652 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP-CCC |
License Number: | 4226 |
Business Practice Address: | 7966 W 790 Rd Hulbert, OK - 744412880 |
Business Phone Number: | 9184783092 |
Business Fax Number: | |
Mailing Address: | Po Box 1963, TAHLEQUAH |
State: | OK |
Postal Code: | 744651963 |
Phone Number: | 9184576713 |
Fax Number: | |
NPI Enumeration Date: | 08/17/2015 |
NPI Last Update Date: | 08/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4226 |
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 |