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General NPI Number Information
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NPI Number | 1952713877
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Entity Type | Individual
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Provider Name | KELLEY BAILEY
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Gender | Female
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 320 N BROADWAY STE 112
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City | EDMOND
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State | OK
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Zip | 73034-3642
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Country | US
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Telephone | 405-601-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 CHAPARRAL LN
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City | EDMOND
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State | OK
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Zip | 73013-6636
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Country | US
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Telephone | 405-474-1813
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | OK
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