Provider Demographics
NPI:1467241125
Name:CORLEY, SARAH RENEE (AAS, SLPA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:CORLEY
Suffix:
Gender:
Credentials:AAS, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11609 SAGAMORE DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6624
Mailing Address - Country:US
Mailing Address - Phone:580-747-3375
Mailing Address - Fax:
Practice Address - Street 1:4301 N SARA RD STE 120
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-3682
Practice Address - Country:US
Practice Address - Phone:405-982-2086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2355S0801X2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant