Individual
MR. KELLY B MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHR
Contact information
Practice address
2732 NW 161ST ST, EDMOND, OK 73013-1218
(405) 202-2466
Mailing address
2732 NW 161ST STREET, EDMOND, OK 73013
(405) 202-2466
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
02/08/2010
Last updated
02/08/2010
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