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Individual

KIRK MICHAEL HOLLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
111 W GRAND AVE, PONCA CITY, OK 74601-5211
(580) 767-8000
Mailing address
3000 LARCHMONT AVE, PONCA CITY, OK 74604-4431
(580) 765-8516

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1900
OK

Other

Enumeration date
02/09/2007
Last updated
07/08/2007
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