Healthcare Provider Details

I. General information

NPI: 1922184514
Provider Name (Legal Business Name): KRISTEN MICHELE COLE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 SE 25TH STREET
OKLAHOMA CITY OK
73129
US

IV. Provider business mailing address

744 SE 25TH STREET
OKLAHOMA CITY OK
73129
US

V. Phone/Fax

Practice location:
  • Phone: 405-636-1463
  • Fax: 405-635-8417
Mailing address:
  • Phone: 405-636-1463
  • Fax: 405-635-8417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number3629
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: