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General NPI Number Information
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NPI Number | 1184183873
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Entity Type | Organization
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Legal Business Name | DAYSTAR COUNSELING & CONSULTING SERVICES, LLC
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 03/13/2019
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Provider Practice Location Address
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Address Line | 7846 US-277 SUITE 3
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City | ELGIN
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State | OK
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Zip | 73538
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Country | US
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Telephone | 580-861-2532
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Fax | 580-670-2563
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Provider Business Mailing Address
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Address Line | 7846 US-277 SUITE 3
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City | ELGIN
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State | OK
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Zip | 73538
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Country | US
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Telephone | 580-861-2532
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Fax | 580-670-2563
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | KIMBERLY ANN COX
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Credential |
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Telephone | 580-861-2532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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