Healthcare Provider Details

I. General information

NPI: 1326977984
Provider Name (Legal Business Name): BECCA LEA WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CHARLES PAGE BLVD
SAND SPRINGS OK
74063-8508
US

IV. Provider business mailing address

1200 S MAIN ST
SAPULPA OK
74066-5542
US

V. Phone/Fax

Practice location:
  • Phone: 918-504-8669
  • Fax:
Mailing address:
  • Phone: 918-534-7405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: