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Individual

MS. KIMBERLY DAWN WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED, ICADC

Contact information

Practice address
2628 MICHAEL DR, EDMOND, OK 73013-5227
(405) 285-1632
Mailing address
2628 MICHAEL DR, EDMOND, OK 73013-5227
(405) 285-1632

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
130
OK

Other

Enumeration date
06/25/2009
Last updated
06/25/2009
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