1700862851 NPI number — PATRICIA B. FOOR M.S., CCC-SLP

Table of content: PATRICIA B. FOOR M.S., CCC-SLP (NPI 1700862851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700862851 NPI number — PATRICIA B. FOOR M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOOR
Provider First Name:
PATRICIA
Provider Middle Name:
B.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOOR
Provider Other First Name:
TRISH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., CCC-SLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1700862851
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4809 WELLMAN WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73072-3700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-447-3140
Provider Business Mailing Address Fax Number:
405-447-6460

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4809 WELLMAN WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73072-3700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-447-3140
Provider Business Practice Location Address Fax Number:
405-447-6460
Provider Enumeration Date:
12/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  2389 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00139667 . This is a "HEALTHCHOICE" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".




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