Provider Demographics
NPI:1497221634
Name:KRUPITZER, KELSIE ANN
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:ANN
Last Name:KRUPITZER
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 1:701 WATERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4370
Mailing Address - Country:US
Mailing Address - Phone:405-630-0605
Mailing Address - Fax:
Practice Address - Street 1:709 SW 119TH ST STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-6080
Practice Address - Country:US
Practice Address - Phone:405-630-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist