Individual
KELSIE SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18360 S HARRAH RD, NEWALLA, OK 74857-7237
(405) 213-7784
Mailing address
18360 S HARRAH RD, NEWALLA, OK 74857-7237
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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