Individual provider · Type 1 NPI

Kelly Divine

Mental Health Counselor · Heavener, OK

NPI number 1740725381 Active

Practice location

511 E 2nd St
Heavener, OK 74937-3419

Call (918) 653-7718 Map

Mailing address

PO Box 846
Heavener, OK 74937-0846

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1740725381

Kelly Divine's National Provider Identifier is 1740725381, issued on Jan 5, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Heavener, OK. The record was last updated on Jan 5, 2017.