Individual
KELLY MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 S CENTRAL AVE, IDABEL, OK 74745-6059
(580) 286-5045
Mailing address
411 S CENTRAL AVE, IDABEL, OK 74745-6059
(580) 286-5045
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
OK
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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