Healthcare Provider Details

I. General information

NPI: 1770075830
Provider Name (Legal Business Name): KELLEN HUGHES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 N BOOMER RD STE B
STILLWATER OK
74075-3526
US

IV. Provider business mailing address

307 E MARIE DR
STILLWATER OK
74075-1621
US

V. Phone/Fax

Practice location:
  • Phone: 405-509-5292
  • Fax:
Mailing address:
  • Phone: 309-333-1886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: