MEDICARE: KAREN PERRY

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1790090652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN PERRY

Provider Business Mailing Address
First Line	:	6009 SE 67TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73135-1736
Country	:	US
Telephone Number	:	405-694-8054
Fax Number	:

Provider Business Practice Location Address
First Line	:	6009 SE 67TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73135-1736
Country	:	US
Telephone Number	:	405-694-8054
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	08/16/2010

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Directions to “ KAREN PERRY ” Practice Location

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