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1306448113
KAELLA R KELLEY
PONCA CITY, OK
NPI
1306448113
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OK N084074652)
Enumeration Date
2020-11-16
Last Update Date
2021-01-22
Business Address
KAELLA R KELLEY
2225 N UNION ST.
PONCA CITY, OK 74601-1536
Phone number: 580-308-5515
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Mailing Address
KAELLA R KELLEY
2225 N UNION ST.
PONCA CITY, OK 74601-1536
Phone number: 580-308-5515
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