Individual
KELVIN GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FACT I RAS
Contact information
Practice address
4851 S DARLINGTON AVE APT 6C, TULSA, OK 74135-7247
(918) 378-0538
Mailing address
4851 S DARLINGTON AVE APT 6C, TULSA, OK 74135-7247
(918) 378-0538
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/25/2017
Last updated
07/19/2017
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