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Organization

DIVERSITY CENTER OF OKLAHOMA

Active
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Organization

DIVERSITY CENTER OF OKLAHOMA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KELLEY BRONNELL BLAIR M.S. (LICENSED PROFESSIONAL COUNSELOR)
(405) 761-7402
Entity
Organization

Contact information

Practice address
6912 CRICKET CANYON RD, OKLAHOMA CITY, OK 73162-6656
(405) 761-7402
Mailing address
6912 CRICKET CANYON, OKLAHOMA CITY, OK 73162
(405) 761-7402

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5944
OK

Other

Enumeration date
01/12/2016
Last updated
09/07/2016
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