Individual
KRISTEN MARIE PAIGE GOODING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
KRISTEN
Contact information
Practice address
109 N FAIRLAND ST, PRYOR, OK 74361-4203
(918) 825-1405
(918) 876-3436
Mailing address
109 N FAIRLAND ST, PRYOR, OK 74361-4203
(918) 825-1405
(918) 876-3436
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
L083238266
OK
Other
Enumeration date
04/30/2019
Last updated
05/22/2019
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