Individual
MR. KELLEY EDWARD TUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2512 S HARVEY AVE, OKLAHOMA CITY, OK 73109-5958
(405) 810-9578
Mailing address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 810-9578
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7179
KS
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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