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1790159382
CARISSA NICOLE KELLEY
SEMINOLE, OK
NPI
1790159382
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-11-19
Last Update Date
2015-11-19
Business Address
Mrs. CARISSA NICOLE KELLEY
2215 W. WRANGLER BLVD. APT. 135
SEMINOLE, OK 74868
Phone number: 405-584-1350
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Mailing Address
Mrs. CARISSA NICOLE KELLEY
2215 W WRANGLER BLVD APT 135
SEMINOLE, OK 74868-2098
Phone number: 405-584-1350
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