MEDICARE: MRS. CAYLA ALLISON ANDERSON MS

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	3399	OK

General Provider Information

NPI Number	:	1386944841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAYLA ALLISON ANDERSON MS

Provider Business Mailing Address
First Line	:	3770 S MADISON AVENUE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105
Country	:	US
Telephone Number	:	407-461-0889
Fax Number	:

Provider Business Practice Location Address
First Line	:	3770 S MADISON AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-3016
Country	:	US
Telephone Number	:	407-461-0889
Fax Number	:

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

Provider Enumeration Date	:	10/29/2010
Last Update Date	:	10/29/2010

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Directions to “ MRS. CAYLA ALLISON ANDERSON MS” Practice Location

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