Organization
CREATIVE SPEECH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMELA COVEY (SPEECH PATHOLOGIST)
(918) 743-3530
Entity
Organization
Contact information
Practice address
2615 E 138TH ST S, BIXBY, OK 74008-3878
(918) 734-7115
Mailing address
PO BOX 471674, TULSA, OK 74147-1674
(918) 734-7115
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2603
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005308803873
BCBSOK
OK
05
—
100677120A
—
OK
01
—
697658
UNITED HEALTHCARE
OK
01
—
7392760
AETNA
OK
Enumeration date
01/25/2007
Last updated
07/30/2009
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