Individual
JENNIFER ANN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3801 NW 166TH ST STE 4, EDMOND, OK 73012-9279
(405) 412-6215
Mailing address
3801 NW 166TH ST STE 4, EDMOND, OK 73012-9279
(405) 412-6215
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3142
OK
Other
Enumeration date
10/06/2014
Last updated
10/31/2022
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