Provider Demographics
NPI:1851019822
Name:ARMSTRONG, KYLEE NICOLE (SLP)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:NICOLE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-6552
Mailing Address - Country:US
Mailing Address - Phone:918-845-7520
Mailing Address - Fax:
Practice Address - Street 1:14540 S 302ND EAST AVE
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-7845
Practice Address - Country:US
Practice Address - Phone:918-486-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF509235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist