Individual
KELLIE SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 S HARVARD AVE, TULSA, OK 74135-2619
(918) 728-2228
Mailing address
12805 E 40TH ST APT 312, TULSA, OK 74146-3523
(918) 734-2754
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/30/2018
Last updated
06/30/2018
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