Individual
KEELY HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 24TH AVE NW, NORMAN, OK 73069-8309
(405) 217-8400
Mailing address
4201 24TH AVE NW, NORMAN, OK 73069-8309
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200130800
—
OK
Enumeration date
12/06/2016
Last updated
12/06/2016
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