MEDICARE: BECCA LEA WATSON

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
1	235Z00000X	Speech-Language Pathologist		OK

General Provider Information

NPI Number	:	1326977984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BECCA LEA WATSON

Provider Business Mailing Address
First Line	:	1200 S MAIN ST
Second Line	:
City	:	SAPULPA
State	:	OK
Zip	:	74066-5542
Country	:	US
Telephone Number	:	918-534-7405
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 E CHARLES PAGE BLVD
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-8508
Country	:	US
Telephone Number	:	918-504-8669
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ BECCA LEA WATSON ” Practice Location

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