Healthcare Provider Details

I. General information

NPI: 1518885128
Provider Name (Legal Business Name): ABBY LEE OLMSTEAD M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NE 3RD ST
KINGSTON OK
73439-8171
US

IV. Provider business mailing address

817 N 11TH AVE
DURANT OK
74701-3731
US

V. Phone/Fax

Practice location:
  • Phone: 580-564-2993
  • Fax:
Mailing address:
  • Phone: 580-916-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCF952
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: