Individual
KALA PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. M.ED.
Contact information
Practice address
304 N BROADWAY, COWETA, OK 74429-2604
(918) 630-3552
Mailing address
6777 E 11TH ST, TULSA, OK 74112-4619
(918) 273-2843
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746170G
—
OK
Enumeration date
04/15/2013
Last updated
10/28/2023
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