Kylie Peterson, MA CCC-SLP
Specialist/Technologist in El Reno, OK. Individual provider (NPI-1).
NPI number1033802426
StatusActive
Last updated in NPPESSep 12, 2024
Details
- NPI
- 1033802426
- Entity type
- Individual (NPI-1)
- Name
- Kylie Peterson
- Credential
- MA CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 31, 2023
- Certification date
- Sep 12, 2024
- Last updated
- Sep 12, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235500000X | Specialist/Technologist | – | – | Yes |
| 235Z00000X | Speech-Language Pathologist, | – | OK |
Practice location
1609 W Elm St Ste BEl Reno, OK 73036-4261
Phone 405-467-6782 · Fax 405-467-6100
Mailing address
1824 Commons Cir Ste BYukon, OK 73099-9538
Phone 405-467-6782 · Fax 405-467-6100
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Speech/Language/Hearing Specialist/Technologist providers in El Reno, OK
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