Provider Demographics
NPI:1053189233
Name:OGLE, MADELYN (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:OGLE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:MADELYN
Other - Middle Name:
Other - Last Name:RYLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12005 N FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7923
Mailing Address - Country:US
Mailing Address - Phone:405-615-8522
Mailing Address - Fax:
Practice Address - Street 1:2200 NE 140TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5784
Practice Address - Country:US
Practice Address - Phone:405-608-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14421939235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist