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General NPI Number Information
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NPI Number | 1689532319
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Entity Type | Organization
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Legal Business Name | KELLEY BLAIR LLC DBA HEALING PLACE 'ALIKCHI'
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 5100 N BROOKLINE AVE STE 630
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-3634
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Country | US
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Telephone | 405-285-2375
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 720520
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City | OKLAHOMA CITY
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State | OK
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Zip | 73172-0520
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Country | US
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Telephone | 405-285-2375
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Fax |
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Authorized Official
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Title or Position | OWENER
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Name | KELLEY BRONNELL BLAIR
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Credential | M.S.
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Telephone | 405-761-7402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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