Healthcare Provider Details

I. General information

NPI: 1205071644
Provider Name (Legal Business Name): JOELLEN TOMLINSON POINDEXTER M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOELLEN LYN TOMLINSON M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 11/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11208 STURBRIDGE RD
OKLAHOMA CITY OK
73162-2162
US

IV. Provider business mailing address

11220 N ROCKWELL AVE
OKLAHOMA CITY OK
73162-2725
US

V. Phone/Fax

Practice location:
  • Phone: 405-721-1667
  • Fax:
Mailing address:
  • Phone: 405-722-6731
  • Fax: 405-722-9463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3154
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: