Healthcare Provider Details

I. General information

NPI: 1235049511
Provider Name (Legal Business Name): KYLEE LYNN MUNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CLEAR SPRINGS RD
MUSTANG OK
73064-1502
US

IV. Provider business mailing address

PO BOX 1280
BETHANY OK
73008-1280
US

V. Phone/Fax

Practice location:
  • Phone: 405-577-5477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: