Individual
MS. LISA JOY KIBBLEWHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3301 NW 21ST ST, OKLAHOMA CITY, OK 73107-3013
(405) 550-9789
Mailing address
3301 NW 21ST ST, OKLAHOMA CITY, OK 73107-3013
(405) 550-9789
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E082497603
—
OK
Enumeration date
09/08/2011
Last updated
01/28/2013
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