Individual
CHARLENE MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6448 NW COLUMBIA AVE, LAWTON, OK 73505-5613
(951) 497-7722
Mailing address
6448 NW COLUMBIA AVE, LAWTON, OK 73505-5613
(951) 497-7722
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
OK
Other
Enumeration date
12/22/2021
Last updated
08/03/2026
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