Healthcare Provider Details

I. General information

NPI: 1083734495
Provider Name (Legal Business Name): K'LYNNE MICHELE ESCOTT LPC, M.S, B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 W 7TH AVE
STILLWATER OK
74074-4105
US

IV. Provider business mailing address

2220 W 7TH AVE
STILLWATER OK
74074-4105
US

V. Phone/Fax

Practice location:
  • Phone: 405-377-1988
  • Fax:
Mailing address:
  • Phone: 405-377-1988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4267
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: