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General NPI Number Information
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NPI Number | 1285030155
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Entity Type | Organization
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Legal Business Name | KIMBERLY A. S PEARS ME, LPC, INC.
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 3855 S BOULEVARD 100
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City | EDMOND
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State | OK
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Zip | 73013-5498
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Country | US
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Telephone | 405-340-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 S BOULEVARD 100
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City | EDMOND
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State | OK
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Zip | 73013-5498
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Country | US
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Telephone | 405-340-4321
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Fax |
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Authorized Official
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Title or Position | LISCENSED PROFESSIONAL COUNSELOR
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Name | MS. KIMBERLY ANN SPEARS
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Credential | M.ED.
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Telephone | 405-340-4321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5379
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License Number State | OK
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