Healthcare Provider Details

I. General information

NPI: 1831440346
Provider Name (Legal Business Name): KATRINA LYNN WILLIAMS-INGRAM CBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2012
Last Update Date: 09/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 NW 48TH ST 201B
OKLAHOMA CITY OK
73112-5900
US

IV. Provider business mailing address

3816 NW 51ST ST
OKLAHOMA CITY OK
73112-2046
US

V. Phone/Fax

Practice location:
  • Phone: 405-905-7087
  • Fax:
Mailing address:
  • Phone: 405-905-7087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: