Individual
MRS. KELLYN RAESHEL GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
Mailing address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 789-6711
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3725
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200427980A
—
OK
Enumeration date
05/18/2010
Last updated
10/19/2015
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