Individual
KIMBERLY WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 SW B AVE, APT 7-24, LAWTON, OK 73501-3828
(580) 340-3950
Mailing address
1401 SW B AVE, APT 7-24, LAWTON, OK 73501-3828
(580) 340-3950
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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