Individual
MIRANDA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1606 E DOWNING ST, TAHLEQUAH, OK 74464-2513
(918) 453-1217
(918) 775-0328
Mailing address
210 N. JT STITES BLVD., SALLISAW, OK 74955-9301
(918) 775-7787
(918) 775-0328
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
11/16/2017
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