Provider Demographics
NPI:1417795808
Name:BARGER, DESTANY M (SLPA)
Entity type:Individual
Prefix:
First Name:DESTANY
Middle Name:M
Last Name:BARGER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 891267
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73189-1267
Mailing Address - Country:US
Mailing Address - Phone:405-464-9595
Mailing Address - Fax:405-493-6787
Practice Address - Street 1:1111 MAGNOLIA CT STE 102
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-1390
Practice Address - Country:US
Practice Address - Phone:405-464-9595
Practice Address - Fax:405-493-6787
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKSLPA3702355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant