Provider Demographics
NPI:1851471247
Name:POLSON, RHODA (MED,CCC)
Entity type:Individual
Prefix:MS
First Name:RHODA
Middle Name:
Last Name:POLSON
Suffix:
Gender:F
Credentials:MED,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 E OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-3416
Mailing Address - Country:US
Mailing Address - Phone:405-282-6700
Mailing Address - Fax:405-260-4261
Practice Address - Street 1:200 S ACADEMY RD
Practice Address - Street 2:REHABILITATION DEPT
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-8727
Practice Address - Country:US
Practice Address - Phone:405-282-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist