Individual
MARIYAH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
13905 TECHNOLOGY DR # A1, OKLAHOMA CITY, OK 73134-1054
(405) 389-4530
Mailing address
12437 SAINT ANDREWS DR APT B, OKLAHOMA CITY, OK 73120-8620
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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