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NPI Code Detail

MEDICARE: SALLY STOEVER SLP

MEDICARE: SALLY STOEVER 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 Pathologist806OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205039450
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY STOEVER SLP
Provider Business Mailing Address
First Line : 2221 W DETROIT ST
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-3628
Country : US
Telephone Number : 918-615-6492
Fax Number : 918-615-6493
Provider Business Practice Location Address
First Line : 2221 W DETROIT ST
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-3628
Country : US
Telephone Number : 918-615-6492
Fax Number : 918-615-6493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2007
Last Update Date : 09/20/2016

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Directions to “ SALLY STOEVER SLP” Practice Location

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