Individual
KELLI BRUMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 S CENTRAL AVE, IDABEL, OK 74745-6059
(580) 286-5045
Mailing address
PO BOX 1030, ANTLERS, OK 74523-1030
(580) 298-2830
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103TR0400X
Rehabilitation Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/22/2009
Last updated
06/05/2012
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