Individual
LUKE ALEXANDER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
429 N UNION AVE, SHAWNEE, OK 74801-7064
(405) 275-1844
Mailing address
1417 LAVERNE AVE, SHAWNEE, OK 74801-5407
(405) 617-5338
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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