MEDICARE: MORGAN MICHELLE O'BRIEN 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	CF4892	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760998850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN MICHELLE O'BRIEN MS

Provider Business Mailing Address
First Line	:	4110 S 100TH EAST AVE STE 107
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3629
Country	:	US
Telephone Number	:	918-248-8102
Fax Number	:	918-248-8104

Provider Business Practice Location Address
First Line	:	4110 S 100TH EAST AVE STE 107
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-3629
Country	:	US
Telephone Number	:	918-248-8102
Fax Number	:	918-248-8104

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

Provider Enumeration Date	:	12/27/2017
Last Update Date	:	12/12/2022

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Directions to “ MORGAN MICHELLE O'BRIEN MS” Practice Location

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