Individual
KIMBERLY CARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6022
OK
Other
Enumeration date
08/27/2014
Last updated
10/31/2017
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