Provider Demographics
NPI:1104098813
Name:OAKES, CHASITY BROOKE (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:CHASITY
Middle Name:BROOKE
Last Name:OAKES
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:MISS
Other - First Name:CHASITY
Other - Middle Name:BROOKE
Other - Last Name:PAULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:3142 POPLAR SPRING RD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-7877
Mailing Address - Country:US
Mailing Address - Phone:270-670-6573
Mailing Address - Fax:
Practice Address - Street 1:3142 POPLAR SPRING RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-7877
Practice Address - Country:US
Practice Address - Phone:270-670-6573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2009-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3577235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist