Individual
JESSICA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 W MAIN ST FL 4, PAWHUSKA, OK 74056-4149
(918) 728-9845
(918) 287-5234
Mailing address
100 W MAIN ST FL 4, PAWHUSKA, OK 74056-4149
(918) 728-9845
(918) 287-5234
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7597
OK
Other
Enumeration date
11/22/2013
Last updated
03/14/2023
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