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NPI Code Detail

MEDICARE: MRS. KATHY AMELIA MORTON MS CCCSLP

MEDICARE: MRS. KATHY AMELIA MORTON MS CCCSLP
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 Pathologist3203OK

Other Identifiers

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

General Provider Information

NPI Number : 1578640579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHY AMELIA MORTON MS CCCSLP
Provider Business Mailing Address
First Line : PO BOX 388
Second Line :
City : EDMOND
State : OK
Zip : 73083-0388
Country : US
Telephone Number : 405-760-6106
Fax Number : 405-720-3501
Provider Business Practice Location Address
First Line : 11220 N ROCKWELL AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-2725
Country : US
Telephone Number : 405-760-6106
Fax Number : 405-720-3501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 05/28/2013

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