Provider Demographics
NPI:1982101226
Name:GARRETT, MEGHAN LORRAINE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LORRAINE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26761 E 143RD ST S
Mailing Address - Street 2:
Mailing Address - City:COWETA
Mailing Address - State:OK
Mailing Address - Zip Code:74429-6764
Mailing Address - Country:US
Mailing Address - Phone:918-208-9162
Mailing Address - Fax:
Practice Address - Street 1:4720 S HARVARD AVE STE 202
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3071
Practice Address - Country:US
Practice Address - Phone:918-747-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4812235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist