Individual
KELLI KAISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 11TH AVE NW, ARDMORE, OK 73401-5826
(580) 504-3072
Mailing address
320 11TH AVE NW, ARDMORE, OK 73401-5826
(580) 504-3072
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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