Individual
KHRYSTAL BLANKENSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.H.R.S.
Contact information
Practice address
314 S BROADWAY AVE, SUITE 106, ADA, OK 74820-5828
(580) 235-0210
(580) 235-0211
Mailing address
PO BOX 662, PURCELL, OK 73080-0662
(405) 527-1785
(405) 527-1084
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
N/A
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746700C
—
OK
Enumeration date
04/09/2010
Last updated
04/09/2010
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