Individual
KELSEY DIANE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-A
Contact information
Practice address
200 2ND AVE SW, MIAMI, OK 74354-6830
(918) 540-7517
Mailing address
64923 E 130 RD, WYANDOTTE, OK 74370-2196
(417) 825-9179
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
OK
Other
Enumeration date
01/29/2021
Last updated
02/19/2021
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