Individual
MRS. KELLI SHANEE SIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
111 E 12TH ST, ADA, OK 74820-6501
(580) 436-2690
Mailing address
111 E 12TH ST, ADA, OK 74820-6501
(580) 436-2690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3329
OK
Other
Enumeration date
01/07/2008
Last updated
01/07/2008
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