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Individual

KIMALA J HUBBARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7401 NE 23RD ST, OKLAHOMA CITY, OK 73141-1420
(405) 408-7029
Mailing address
3704 OAK GROVE DR, MIDWEST CITY, OK 73110-3730
(405) 408-7029

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11194
OKLAHOMA DEPARTMENT OF MENTAL HEALTH
OK
Enumeration date
06/25/2011
Last updated
07/13/2021
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