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1992065619
MARCUS JEROME KELLY
MOORE, OK
NPI
1992065619
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OK 081111886)
Enumeration Date
2012-05-29
Last Update Date
2012-05-29
Business Address
-- MARCUS JEROME KELLY
1805 MEAD LN
MOORE, OK 73170-1472
Phone number: 405-201-8496
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Mailing Address
-- MARCUS JEROME KELLY
1805 MEAD LN
MOORE, OK 73170-1472
Phone number: 405-201-8496
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