Organization
SPEECH PATHWAYS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE OWEN SHELTON PHD (SPEECH LANGUAGE PATHOLOGIST)
(580) 223-1313
Entity
Organization
Contact information
Practice address
812 12TH AVE NW, ARDMORE, OK 73401-5708
(580) 223-1313
(580) 223-1629
Mailing address
1002 STANLEY ST SW, ARDMORE, OK 73401-4638
(580) 226-5210
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
441868611-001
BCBS 12 DIGIT #
OK
Enumeration date
05/11/2006
Last updated
08/22/2020
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