Provider Demographics
NPI:1669717757
Name:KELIH, TOD WILLIAM (BHRS)
Entity type:Individual
Prefix:
First Name:TOD
Middle Name:WILLIAM
Last Name:KELIH
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 NW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-1834
Mailing Address - Country:US
Mailing Address - Phone:405-528-0460
Mailing Address - Fax:
Practice Address - Street 1:3416 NW 28TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-1834
Practice Address - Country:US
Practice Address - Phone:405-528-0460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor