Individual
KYLIE JEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1029 E WASHINGTON AVE, MCALESTER, OK 74501-4849
(918) 423-2220
Mailing address
302 W SPRINGER AVE, MCALESTER, OK 74501-2426
(918) 448-4726
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5501
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G083353908
OKLAHOMA DRIVERS LICENSE
OK
Enumeration date
06/20/2019
Last updated
02/26/2024
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