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Individual

MISS KRYSTAL DAWN HALTOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A, LPC

Contact information

Practice address
6801 S WESTERN AVE STE 101, OKLAHOMA CITY, OK 73139-1816
(405) 550-2688
(405) 619-3924
Mailing address
6801 S WESTERN AVE STE 101, OKLAHOMA CITY, OK 73139-1816
(405) 550-2688
(405) 619-3924

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6323
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1164939765
WORK NPI
OK
05
200375440B
OK
05
200781380A
OK
01
82-0996935
DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE
OK
Enumeration date
05/20/2010
Last updated
02/24/2026
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