Healthcare Provider Details

I. General information

NPI: 1629639687
Provider Name (Legal Business Name): KELSEY ELLEN CASE M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 S DOUGLAS BLVD STE F
MIDWEST CITY OK
73130-5265
US

IV. Provider business mailing address

1117 S DOUGLAS BLVD STE F
MIDWEST CITY OK
73130-5265
US

V. Phone/Fax

Practice location:
  • Phone: 405-368-6751
  • Fax:
Mailing address:
  • Phone: 405-368-6751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4674
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: