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General NPI Number Information
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NPI Number | 1841731411
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Entity Type | Organization
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Legal Business Name | KEELEE BRIGHT, LLC
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 437 W WILSHIRE BLVD STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7747
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Country | US
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Telephone | 405-200-5667
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Fax |
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Provider Business Mailing Address
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Address Line | 437 W WILSHIRE BLVD STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7747
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KEELEE BRIGHT
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Credential |
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Telephone | 405-200-5667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | #6159
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License Number State | OK
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