Divine, Kelly

Divine, Kelly is an individual health care provider with primary practice located at 511 E 2Nd St , Heavener OK 74937-3419. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Divine, Kelly can be contacted via phone (918) 653-7718.

Contact Information

Primary practice address
511 E 2Nd St Heavener OK 74937-3419
Phone: (918) 653-7718
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1740725381
LBN Legal business name Divine, Kelly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2017
Last updated Jan 5th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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