Individual
MRS. KIMBERLY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 S BROADWAY AVE, SUITE 402, ADA, OK 74820-5820
(580) 235-0274
(580) 235-0277
Mailing address
312 PAYTON PLACE LAKE HLS, ADA, OK 74820-4201
(405) 584-0403
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2014
Last updated
05/31/2016
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