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Individual

MRS. KIM MICHELLE TURNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
118 N OAK ST, PONCA CITY, OK 74601-4238
(580) 763-7177
(580) 762-1066
Mailing address
118 N OAK ST, PONCA CITY, OK 74601-4238
(580) 763-7177
(580) 762-1066

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
K080413278
OK
101YM0800X
Mental Health Counselor
Primary
K080413278
OK

Other

Enumeration date
02/15/2010
Last updated
02/15/2010
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