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NPI Code Detail

MEDICARE: MISS MELIA AMBER MARTIN SLP

MEDICARE: MISS MELIA AMBER MARTIN 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
1235Z00000XSpeech-Language Pathologist3070OK

General Provider Information

NPI Number : 1720163686
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MELIA AMBER MARTIN SLP
Provider Business Mailing Address
First Line : 700 NW 51ST ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-6216
Country : US
Telephone Number : 405-919-1112
Fax Number :
Provider Business Practice Location Address
First Line : 8827 E RENO AVE
Second Line : SUITE 201
City : OKLAHOMA CITY
State : OK
Zip : 73110-7732
Country : US
Telephone Number : 405-610-3048
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/21/2022

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Directions to “ MISS MELIA AMBER MARTIN SLP” Practice Location

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