Individual
MR. KYLE RYAN WESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHR
Contact information
Practice address
7147 S BRADEN AVE, TULSA, OK 74136-6302
(918) 688-8882
Mailing address
5220 S POPLAR AVE, BROKEN ARROW, OK 74011-4282
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4892
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740309053
—
OK
Enumeration date
03/28/2007
Last updated
10/25/2018
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