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General NPI Number Information
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NPI Number | 1144101072
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Entity Type | Individual
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Provider Name | KATHLEEN RENEE LAW
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Gender | Female
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 29692 E HWY 51
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City | COWETA
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State | OK
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Zip | 74429
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Country | US
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Telephone | 918-486-5564
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Fax |
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Provider Business Mailing Address
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Address Line | 505 S MAIN ST
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City | PORTER
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State | OK
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Zip | 74454-1015
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Country | US
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Telephone | 918-483-0111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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