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NPI Code Detail

MEDICARE: MRS. RUBY AUSTIN M.S. CCC-SLP

MEDICARE: MRS. RUBY AUSTIN M.S. 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 Pathologist3441OK

General Provider Information

NPI Number : 1194900886
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUBY AUSTIN M.S. CCC-SLP
Provider Business Mailing Address
First Line : 500 ROSS AVE
Second Line :
City : FORT GIBSON
State : OK
Zip : 74434-8422
Country : US
Telephone Number : 918-478-4841
Fax Number :
Provider Business Practice Location Address
First Line : 500 ROSS AVE
Second Line :
City : FORT GIBSON
State : OK
Zip : 74434-8422
Country : US
Telephone Number : 918-478-4841
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2008
Last Update Date : 08/18/2015

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Directions to “ MRS. RUBY AUSTIN M.S. CCC-SLP” Practice Location

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