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General NPI Number Information
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NPI Number | 1063877736
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Entity Type | Individual
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Provider Name | JAZMINE RENA O'KELLEY ED.S.
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Gender | Female
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 12/23/2015
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Provider Practice Location Address
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Address Line | 1405 E MOSES
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City | CUSHING
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State | OK
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Zip | 74023
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Country | US
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Telephone | 918-225-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 E MOSES
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City | CUSHING
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State | OK
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Zip | 74023
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Country | US
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Telephone | 918-225-5600
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Fax | 918-225-3026
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 238194
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License Number State | OK
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