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NPI Code Detail

MEDICARE: ANETRA KINSLOW

MEDICARE: ANETRA KINSLOW
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 : 1588981203
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANETRA KINSLOW
Provider Business Mailing Address
First Line : 3035 NW 63RD ST STE 201
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-3606
Country : US
Telephone Number : 405-842-8801
Fax Number :
Provider Business Practice Location Address
First Line : 3035 NW 63RD ST STE 201
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-3606
Country : US
Telephone Number : 405-842-8801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2010
Last Update Date : 04/21/2010

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Directions to “ ANETRA KINSLOW ” Practice Location

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