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1689003741
KELLY LAVINE
TULSA, OK
NPI
1689003741
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2013-11-08
Last Update Date
2013-11-08
Business Address
-- KELLY LAVINE
10217 E 21ST PL
TULSA, OK 74129-4602
Phone number: 918-671-1934
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Mailing Address
-- KELLY LAVINE
10217 E 21ST PL
TULSA, OK 74129-4602
Phone number: 918-671-1934
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