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Individual

KIMBERLY LABASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1608 S ELWOOD AVE, TULSA, OK 74119-4208
(918) 587-3888
(918) 587-3891
Mailing address
1608 S. ELWOOD AVE, TULSA, OK 74119
(918) 587-3888
(918) 587-3891

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200087380 A
OK
Enumeration date
03/11/2009
Last updated
03/11/2009
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