Provider Demographics
NPI:1659653111
Name:TURNER, KELLY (AUD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 N MEMORIAL
Mailing Address - Street 2:SUITE 116
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120
Mailing Address - Country:US
Mailing Address - Phone:405-607-8222
Mailing Address - Fax:866-322-0876
Practice Address - Street 1:3330 NW 56TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4479
Practice Address - Country:US
Practice Address - Phone:405-607-8222
Practice Address - Fax:866-322-0876
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3761231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist