Provider Demographics
NPI:1851029599
Name:STONE, KELSEY B (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:B
Last Name:STONE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-3417
Mailing Address - Country:US
Mailing Address - Phone:580-606-0207
Mailing Address - Fax:
Practice Address - Street 1:1030 ASH AVE
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:OK
Practice Address - Zip Code:73529-2636
Practice Address - Country:US
Practice Address - Phone:580-439-2911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5308235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist