Individual
KELLY ROSE WHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
416 NW 23RD ST, OKLAHOMA CITY, OK 73103
(405) 310-7463
Mailing address
616 NW 21ST ST STE 105, OKLAHOMA CITY, OK 73103-1861
(405) 310-7463
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5054
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200454620A
—
OK
Enumeration date
09/10/2012
Last updated
07/06/2022
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