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Marcus Jerome Kelly
Mental Health Counselor in Moore, Oklahoma
NPI 1992065619

Marcus Jerome Kelly is a Mental Health Counselor based in Moore, OK and is specialized in Mental Health. Marcus Jerome Kelly practices in Moore, OK. The NPI Number for Marcus Jerome Kelly is 1992065619 and holds a License No. 081111886 (Oklahoma).

The current practice location address for Marcus Jerome Kelly is 1805 Mead Ln, Moore, OK and can be reached out via phone at 405-201-8496.

Location: 1805 Mead Ln, Moore, OK, 73170-1472
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1992065619
Provider Name
Marcus Jerome Kelly
Credential
Provider Entity Type
Individual
Gender
Male
Address
1805 Mead Ln, Moore, OK, 73170-1472
Phone Number
405-201-8496
Fax Number
Provider Enumeration Date
05/29/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1805 Mead Ln
City
Moore
State
Oklahoma
Zip
73170-1472
Phone Number
405-201-8496
Fax Number
person
Provider Business Mailing Address Details
Address
1805 Mead Ln
City
Moore
State
Oklahoma
Zip
73170-1472
Phone Number
405-201-8496
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
081111886 (Oklahoma)
Definition
Definition to come...
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