Mitzi Davis Booth in Broken Arrow - Speech-language Pathologist
Mitzi Davis Booth - NPI 1750469722
Mitzi Davis Booth is a Speech-language Pathologist in Broken Arrow, Oklahoma. Mitzi Davis Booth practices all healthcare services and medical treatments related to Speech-language Pathologist. The NPI Number for Mitzi Davis Booth is 1750469722. The last update date is 2010-05-19.
Mitzi Davis Booth's current location address is 2208 W Detroit St Ste 202, Broken Arrow, Oklahoma. You can contact this provider via phone number 9188060106 and fax number 9188060113. The mailing address for Mitzi Davis Booth is 2208 W Detroit St Ste 202, Broken Arrow, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mitzi Davis Booth |
|---|---|
| Address | 2208 W Detroit St Ste 202, Broken Arrow, Oklahoma |
| Phone Number | 9188060106 |
| Fax Number | 9188060113 |
| Sole Proprietor | N |
| Credentials | MS, CCC-SL |
NPI Number Detail
| NPI Number | 1750469722 |
|---|---|
| Provider Enumeration Date | 2006-11-01 |
| Last Updated Date | 2010-05-19 |
Provider Mailing Address Detail
| Address | 2208 W Detroit St Ste 202 |
|---|---|
| City | Broken Arrow |
| State | Oklahoma (OK) |
| Post Code | 740123642 |
| Phone Number | 9188060106 |
| Fax Number | 9188060113 |
Provider's Primary Taxonomy Detail
| Speciality | Speech-language Pathologist |
|---|---|
| Taxonomy | 235Z00000X |
| Licence No | 3142 |
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Definition: The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Spe |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| Y200061310A | OK | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Mitzi Davis Booth by the Centers for Medicare & Medicaid Services?
The Mitzi Davis Booth has been issued the NPI (National Provider Identifier) 1750469722. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Mitzi Davis Booth?
The Mitzi Davis Booth is situated at 2208 W Detroit St Ste 202, in the city of Broken Arrow, state of OK, with the zip code 740123642.
What is the Mitzi Davis Booth's specialty and taxonomy code?
The Mitzi Davis Booth's specialty is Speech-language Pathologist, and the corresponding taxonomy code is 235Z00000X.
When was the Mitzi Davis Booth's 1750469722 issued?
The Mitzi Davis Booth's 1750469722 was issued on 2006-11-01.
As of what date were the details related to Mitzi Davis Booth most recently updated or revised?
The information pertaining to Mitzi Davis Booth, including its address, specialty, and other relevant details, was last updated or revised on 2010-05-19.