MEDICARE: MRS. CHRISTA SHEREE COLLINS M.S. CFY-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
1	235Z00000X	Speech-Language Pathologist	3910	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1578855102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTA SHEREE COLLINS M.S. CFY-SLP

Provider Business Mailing Address
First Line	:	PO BOX 15
Second Line	:
City	:	JONES
State	:	OK
Zip	:	73049-0015
Country	:	US
Telephone Number	:	405-397-3550
Fax Number	:	405-399-2350

Provider Business Practice Location Address
First Line	:	1620 MIDTOWN PLACE
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6217
Country	:	US
Telephone Number	:	405-397-3550
Fax Number	:	405-399-2350

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

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	09/27/2019

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Directions to “ MRS. CHRISTA SHEREE COLLINS M.S. CFY-SLP” Practice Location

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