Individual
KELLEY MARICLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1728 S CARSON AVE, TULSA, OK 74119-4610
(918) 637-9937
Mailing address
2104 W H ST, JENKS, OK 74037-2355
(918) 637-9937
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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