Individual
JENNIFER LYNN KEEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2028 LANKESTAR PL, YUKON, OK 73099-7808
(405) 324-0350
Mailing address
2028 LANKESTAR PL, YUKON, OK 73099-7808
(405) 324-0350
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1029
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01002142
ASHA ID / ACCOUNT NUMBER
OK
01
—
1029
STATE LICENSURE NUMBER
OK
Enumeration date
11/03/2006
Last updated
07/08/2007
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