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NPI Code Detail

MEDICARE: MRS. KELLY CATHERINE SPIVA M.A.,CCC-A

MEDICARE: MRS. KELLY CATHERINE SPIVA M.A.,CCC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist291OK

General Provider Information

NPI Number : 1922003946
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLY CATHERINE SPIVA M.A.,CCC-A
Provider Business Mailing Address
First Line : 6802 S OLYMPIA AVE STE 200
Second Line :
City : TULSA
State : OK
Zip : 74132-1826
Country : US
Telephone Number : 918-388-9090
Fax Number : 918-388-9741
Provider Business Practice Location Address
First Line : 6802 S OLYMPIA AVE STE 200
Second Line :
City : TULSA
State : OK
Zip : 74132-1826
Country : US
Telephone Number : 918-388-9090
Fax Number : 918-388-9741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 08/22/2023

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Directions to “ MRS. KELLY CATHERINE SPIVA M.A.,CCC-A” Practice Location

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