Individual
TIARA DONN MCKENSIE KRUTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105828 S PARKWOOD MEADOWS DR, MCLOUD, OK 74851-9683
(405) 305-7210
Mailing address
13501 SE 29TH ST TRLR 121, CHOCTAW, OK 73020-6652
(405) 305-7210
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
12041
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/09/2023
Last updated
09/09/2025
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