Individual
MS. KATHY L ISHCOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1200 E TAMARACK RD, ALTUS, OK 73521-1234
(580) 379-6850
Mailing address
1200 E TAMARACK RD, ALTUS, OK 73521-1234
(580) 379-6850
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4258
OK
Other
Enumeration date
11/17/2011
Last updated
03/28/2012
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