Provider Demographics
NPI:1265871214
Name:HADDAD, SYNTHIA (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SYNTHIA
Middle Name:
Last Name:HADDAD
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 1:125 S PICKARD AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-5451
Mailing Address - Country:US
Mailing Address - Phone:405-596-3689
Mailing Address - Fax:
Practice Address - Street 1:125 S PICKARD AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5451
Practice Address - Country:US
Practice Address - Phone:405-596-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK338235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist