Individual
BRENDA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC U/S
Contact information
Practice address
1719 SW 11TH ST, LAWTON, OK 73501-7305
(580) 581-1818
Mailing address
1719 SW 11TH ST, LAWTON, OK 73501-7305
(580) 581-1818
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
U/S
OK
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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