Individual
KRYSTLE ELAINE COUNTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A., CM II
Contact information
Practice address
106 S 3RD ST, MCALESTER, OK 74501-5300
(918) 421-8880
Mailing address
91 W HALL RD, STUART, OK 74570-5192
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
310780
OK
Other
Enumeration date
06/06/2011
Last updated
08/25/2021
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