Individual
KATHRYN NICOLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1809 COMMONS CIR STE B, YUKON, OK 73099-9528
(405) 324-0961
Mailing address
9608 LAKE LN, OKLAHOMA CITY, OK 73162-7444
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4407
OK
Other
Enumeration date
06/18/2015
Last updated
06/26/2015
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