Provider Demographics
NPI:1134157845
Name:MURPHY, MICHELLE L (MS SLP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 N YELLOWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-9102
Mailing Address - Country:US
Mailing Address - Phone:918-286-1261
Mailing Address - Fax:918-286-1265
Practice Address - Street 1:2208 N YELLOWOOD AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-9102
Practice Address - Country:US
Practice Address - Phone:918-286-1261
Practice Address - Fax:918-286-1265
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100638860Medicaid