Individual
KIM HEWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 MAGNOLIA ST, TAHLEQUAH, OK 74464-4818
(918) 207-9519
Mailing address
405 MAGNOLIA ST, TAHLEQUAH, OK 74464-4818
(918) 207-9519
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/04/2015
Last updated
03/08/2023
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