Provider Demographics
NPI:1194996678
Name:COX, FARAH BROOKE
Entity type:Individual
Prefix:MRS
First Name:FARAH
Middle Name:BROOKE
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4804 NW 161ST TER
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3234
Mailing Address - Country:US
Mailing Address - Phone:405-226-4911
Mailing Address - Fax:
Practice Address - Street 1:4804 NW 161ST TER
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3234
Practice Address - Country:US
Practice Address - Phone:405-226-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2921235Z00000X
OK12042106 ASHA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1194996678Medicaid