Individual
MRS. PAMELA SUE KERKSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2525 3RD AVE NE, ARDMORE, OK 73401-8122
(580) 223-2142
Mailing address
2525 3RD AVE NE, ARDMORE, OK 73401-8122
(580) 223-2142
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3453
OK
Other
Enumeration date
10/03/2008
Last updated
10/03/2008
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