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NPI Code Detail

MEDICARE: KATIE MUTER

MEDICARE: KATIE MUTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1033930946
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE MUTER
Provider Business Mailing Address
First Line : 333 W MAIN ST STE 140
Second Line :
City : ARDMORE
State : OK
Zip : 73401-6321
Country : US
Telephone Number : 580-224-2929
Fax Number :
Provider Business Practice Location Address
First Line : 333 W MAIN ST STE 140
Second Line :
City : ARDMORE
State : OK
Zip : 73401-6321
Country : US
Telephone Number : 580-224-2929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2024
Last Update Date : 10/23/2024

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Directions to “ KATIE MUTER ” Practice Location

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