Individual
MRS. MELISSA DAWN BINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A,, CCC-SLP
Contact information
Practice address
5110 S YALE AVE, SUITE 102, TULSA, OK 74135-7401
(918) 497-6554
(918) 645-8686
Mailing address
14483 S 209TH EAST AVE, COWETA, OK 74429-6314
(918) 279-0811
(918) 279-0811
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2449
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10063870B
—
OK
05
—
10063870C
—
OK
Enumeration date
09/25/2006
Last updated
07/11/2011
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