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NPI Code Detail

MEDICARE: CAROL BERG

MEDICARE: CAROL BERG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist4233OK

General Provider Information

NPI Number : 1083029631
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL BERG
Provider Business Mailing Address
First Line : 9439 E 81ST ST APT 413
Second Line :
City : TULSA
State : OK
Zip : 74133-8103
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6715 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74145-4520
Country : US
Telephone Number : 918-806-0013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2014
Last Update Date : 06/26/2015

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Directions to “ CAROL BERG ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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