Individual
KELLI BROOKE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
5500 N WESTERN AVE, SUITE 153, OKLAHOMA CITY, OK 73118-4019
(405) 286-3749
(866) 435-3297
Mailing address
2612 SE 39TH ST, MOORE, OK 73160-0642
(405) 378-2929
(866) 435-3297
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3036
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200063320B
—
OK
Enumeration date
04/18/2006
Last updated
04/18/2011
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