Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellie Odeneal

Individual provider Peer Specialist · NPI 1720707532

Kellie Odeneal is a Peer Specialist in Wagoner, Oklahoma. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

907 NW 5th St
Wagoner, OK 74467-3103
Phone: (918) 777-1241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X

Record details

NPI number1720707532
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 24, 2022
Last updated in NPPESAugust 24, 2022
Certification dateAugust 24, 2022
Mailing address907 Nw 5th St, Wagoner, OK 74467-3103

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