Individual
KNEALE EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6216 S LEWIS AVE, SUITE 180, TULSA, OK 74136-1044
(918) 960-7852
Mailing address
PO BOX 1206, JENKS, OK 74037-1206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3664
OK
Other
Enumeration date
11/27/2006
Last updated
09/28/2011
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