Individual
KAYLEY YBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHCM II
Contact information
Practice address
6 E LAFAYETTE AVE, COALGATE, OK 74538-2676
(580) 927-3168
Mailing address
PO BOX 1710, KINGSTON, OK 73439
(580) 745-9610
(580) 745-9891
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100708380
—
OK
05
—
200049040
—
OK
05
—
200428190
—
OK
Enumeration date
03/31/2016
Last updated
02/15/2022
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