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NPI Code Detail

MEDICARE: CINDY A DOTSON M.ED.CCC-SLP

MEDICARE: CINDY A DOTSON M.ED.CCC-SLP
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 Pathologist1033OK

General Provider Information

NPI Number : 1144438805
Entity Type Code : Individual
Provider Name (Legal Business Name) : CINDY A DOTSON M.ED.CCC-SLP
Provider Business Mailing Address
First Line : 5540 S 257TH EAST AVE
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74014-4435
Country : US
Telephone Number : 918-357-5208
Fax Number :
Provider Business Practice Location Address
First Line : 320 N 4TH AVE
Second Line :
City : STROUD
State : OK
Zip : 74079-3641
Country : US
Telephone Number : 918-968-2656
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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Directions to “ CINDY A DOTSON M.ED.CCC-SLP” Practice Location

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