Individual
KIMBERLY DENISE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16108 E 2ND ST, TULSA, OK 74108-1729
(918) 864-9536
Mailing address
16108 E 2ND ST, TULSA, OK 74108-1729
(918) 864-9536
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200293900A
—
OK
Enumeration date
01/07/2011
Last updated
01/07/2011
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