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Individual

KATHLEEN MARIE HORTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
ROUTE 1 BOX 35 D, BOLEY, OK 74829-0295
(918) 667-9967
(918) 667-3387
Mailing address
PO BOX 295, BOLEY, OK 74829-0295
(918) 667-9967
(918) 667-3387

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3598
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100734620D
OK
Enumeration date
07/10/2008
Last updated
06/14/2012
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