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General NPI Number Information
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NPI Number | 1417226473
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Entity Type | Individual
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Provider Name | KIMBERLY ANN BEAIR LPC
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Gender | Female
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 6030 E. 66TH E. AVE
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City | TULSA
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State | OK
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Zip | 74145
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Country | US
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Telephone | 918-809-6953
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Fax |
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Provider Business Mailing Address
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Address Line | 6030 S 66TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74145-9236
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Country | US
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Telephone | 918-809-6953
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1172
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License Number State | OK
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