Provider Demographics
NPI:1730724469
Name:HARL, JAMI PAIGE
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:PAIGE
Last Name:HARL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7201
Mailing Address - Country:US
Mailing Address - Phone:919-605-7091
Mailing Address - Fax:
Practice Address - Street 1:2485 E 54TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7201
Practice Address - Country:US
Practice Address - Phone:919-605-7091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01080699OtherAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION
OK721OtherOKLAHOMA BOARD OF EXAMINERS FOR SPEECH PATHOLOGY
FL81221OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH