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Individual

MS. KAREN LYNN KISSICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CASE MANAGER

Contact information

Practice address
4000 E CHARTER OAK RD, GUTHRIE, OK 73044-9263
(405) 282-4093
Mailing address
3950 E CHARTER OAK RD, GUTHRIE, OK 73044-9263
(405) 282-4093
(866) 941-8550

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200382030A
OK
01
300201
CERTIFIED BEHAVIORAL HEALTH CASE MANAGER, LEVEL CM II
OK
Enumeration date
12/29/2010
Last updated
09/20/2024
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