MEDICARE: JOLE'SA ARNETTE DAY

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	4513	OK

General Provider Information

NPI Number	:	1407342538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOLE'SA ARNETTE DAY

Provider Business Mailing Address
First Line	:	16775 E 115TH ST N
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-5770
Country	:	US
Telephone Number	:	918-829-9303
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W 46TH ST N
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74126-6675
Country	:	US
Telephone Number	:	918-829-9309
Fax Number	:

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

Provider Enumeration Date	:	07/01/2018
Last Update Date	:	07/01/2018

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Directions to “ JOLE'SA ARNETTE DAY ” Practice Location

Language	Start Address	Practice Location

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