Individual
JOE KHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-C
Contact information
Practice address
1400 SE 4TH ST, MOORE, OK 73160-7329
(405) 837-1033
Mailing address
1400 SE 4TH ST, MOORE, OK 73160-7329
(405) 837-1033
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200732080A
—
OK
Enumeration date
09/01/2020
Last updated
09/01/2020
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