Individual
KEELEN D ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
805 E ROBINSON ST, NORMAN, OK 73071-6610
(405) 447-4499
Mailing address
3313 NE 14TH PL, OKLAHOMA CITY, OK 73117-6211
(817) 243-9129
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/10/2024
Last updated
10/07/2024
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