Provider Demographics
NPI:1326367947
Name:KELLEY, MAUREEN LESLIE (BHRS)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:LESLIE
Last Name:KELLEY
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NE 50TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-1811
Mailing Address - Country:US
Mailing Address - Phone:405-235-7537
Mailing Address - Fax:405-528-5754
Practice Address - Street 1:201 NE 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-1811
Practice Address - Country:US
Practice Address - Phone:405-235-7537
Practice Address - Fax:405-528-5754
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor