Provider Demographics
NPI:1326249343
Name:MILLER, KELA JILL (AUD)
Entity Type:Individual
Prefix:DR
First Name:KELA
Middle Name:JILL
Last Name:MILLER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:KELA
Other - Middle Name:JILL
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:9409 N MAY AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120
Mailing Address - Country:US
Mailing Address - Phone:405-748-3600
Mailing Address - Fax:405-945-7188
Practice Address - Street 1:9409 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120
Practice Address - Country:US
Practice Address - Phone:405-748-3600
Practice Address - Fax:405-945-7188
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK350231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist