Individual
KILEY ELLEGARD MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
437 W WILSHIRE BLVD STE A, OKLAHOMA CITY, OK 73116-7747
(405) 229-9514
Mailing address
437 W WILSHIRE BLVD STE A, OKLAHOMA CITY, OK 73116-7747
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/01/2012
Last updated
08/01/2017
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