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NPI Code Detail

MEDICARE: TYELINDA BAUMGARDNER MS, CCC-SLP

MEDICARE: TYELINDA BAUMGARDNER MS, CCC-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 Pathologist3010OK

General Provider Information

NPI Number : 1891064259
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYELINDA BAUMGARDNER MS, CCC-SLP
Provider Business Mailing Address
First Line : 10042 SOUTHRIDGE DR
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-7329
Country : US
Telephone Number : 405-613-5367
Fax Number : 405-942-4895
Provider Business Practice Location Address
First Line : 2416 N ANN ARBOR AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73127-1811
Country : US
Telephone Number : 405-942-4895
Fax Number : 405-942-4895
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2011
Last Update Date : 12/14/2011

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Directions to “ TYELINDA BAUMGARDNER MS, CCC-SLP” Practice Location

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