Provider Demographics
NPI:1679762678
Name:DUKE, KELLY LEE (OTR)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:LEE
Last Name:DUKE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-1645
Mailing Address - Country:US
Mailing Address - Phone:405-420-4585
Mailing Address - Fax:
Practice Address - Street 1:1919 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-1645
Practice Address - Country:US
Practice Address - Phone:405-420-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist