Provider Demographics
NPI:1619668829
Name:FISHER, KEHLEY EVE (OTD)
Entity Type:Individual
Prefix:
First Name:KEHLEY
Middle Name:EVE
Last Name:FISHER
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17110 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-9279
Mailing Address - Country:US
Mailing Address - Phone:573-541-1028
Mailing Address - Fax:
Practice Address - Street 1:17110 E 51ST ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-9279
Practice Address - Country:US
Practice Address - Phone:573-541-1028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist