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General NPI Number Information
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NPI Number | 1053597377
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Entity Type | Organization
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Legal Business Name | KATHLEEN WARD, PHD, PC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 609 S 2ND ST
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City | MCALESTER
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State | OK
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Zip | 74501-5813
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Country | US
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Telephone | 918-302-0203
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Fax | 918-423-7002
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Provider Business Mailing Address
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Address Line | 609 S 2ND ST
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City | MCALESTER
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State | OK
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Zip | 74501-5813
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Country | US
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Telephone | 918-302-0203
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Fax | 918-423-7002
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Authorized Official
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Title or Position | CEO
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Name | DR. KATHLEEN WARD
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Credential | PH.D.
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Telephone | 918-302-0203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 924
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License Number State | OK
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