Individual
KEVIN LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5104
(405) 424-7711
Mailing address
1900 NW 176TH ST, EDMOND, OK 73012-6982
(405) 762-6077
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
OK
Other
Enumeration date
10/12/2023
Last updated
03/26/2024
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