Provider Demographics
NPI:1922381623
Name:HARDER, KELSEY LEIGH (BS)
Entity Type:Individual
Prefix:MISS
First Name:KELSEY
Middle Name:LEIGH
Last Name:HARDER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MRS
Other - First Name:KELSEY
Other - Middle Name:LEIGH
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:2530 S COMMERCE ST BLDG B
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-5519
Mailing Address - Country:US
Mailing Address - Phone:580-223-5509
Mailing Address - Fax:580-226-6727
Practice Address - Street 1:2530 S COMMERCE ST BLDG B
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5519
Practice Address - Country:US
Practice Address - Phone:580-223-5509
Practice Address - Fax:580-226-6727
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor