Individual
LAUREN KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
Mailing address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/12/2012
Last updated
02/13/2017
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