Individual
KIMBERLY S PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
10310 N 138TH EAST AVE STE 201, OWASSO, OK 74055-4641
(918) 520-1202
(918) 340-6383
Mailing address
10310 N 138TH EAST AVE STE 201, OWASSO, OK 74055-4641
(918) 520-1202
(918) 340-6383
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881842870
—
OK
Enumeration date
09/03/2008
Last updated
12/14/2023
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