Individual
MS. KELLY RAE LESLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
62 WHIPPOORWILL RD, PONCA CITY, OK 74604-6097
(580) 716-9335
Mailing address
62 WHIPPOORWILL RD, PONCA CITY, OK 74604-6097
(580) 716-9335
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/16/2011
Last updated
03/03/2023
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