Individual
THERESA DENISE KLOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16400 CLEAR CREEK DR, EDMOND, OK 73013-1249
(405) 684-4913
Mailing address
16400 CLEAR CREEK DR, EDMOND, OK 73013-1249
(405) 684-4913
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200120060A
—
OK
Enumeration date
05/27/2010
Last updated
10/24/2023
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