Provider Demographics
NPI:1407159163
Name:SAUNDERS-FERGUSON, KELLEE
Entity Type:Individual
Prefix:
First Name:KELLEE
Middle Name:
Last Name:SAUNDERS-FERGUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLEE
Other - Middle Name:
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2309 NW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2523
Mailing Address - Country:US
Mailing Address - Phone:316-619-1102
Mailing Address - Fax:
Practice Address - Street 1:2309 NW 28TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2523
Practice Address - Country:US
Practice Address - Phone:316-619-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst