Provider Demographics
NPI:1396509071
Name:JAMES, MICAH SHAE
Entity type:Individual
Prefix:MRS
First Name:MICAH
Middle Name:SHAE
Last Name:JAMES
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 1:706 N ROSS ST
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-3139
Mailing Address - Country:US
Mailing Address - Phone:539-525-4960
Mailing Address - Fax:
Practice Address - Street 1:14002 E 21ST ST STE 650
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134-1432
Practice Address - Country:US
Practice Address - Phone:918-274-7902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist