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Individual

MRS. KIM STANFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
716 S 2ND ST # 1014, STILWELL, OK 74960-4806
(919) 696-6212
(918) 696-6213
Mailing address
162 ALYENE DR, STILWELL, OK 74960-3230
(918) 575-2695

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
06968
OK

Other

Enumeration date
04/27/2016
Last updated
10/03/2025
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