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NPI 1427212281

NPI 1427212281 : KATHLEEN MARIE HORTON : BOLEY, OK

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General NPI Number Information
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    NPI Number           |    1427212281
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    Entity Type          |    Individual 
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    Provider Name        |    KATHLEEN MARIE HORTON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/10/2008
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    Last Update Date     |    06/14/2012
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Provider Practice Location Address
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    Address Line         |    ROUTE 1 BOX 35 D 
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    City                 |    BOLEY
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    State                |    OK
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    Zip                  |    74829-0295
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    Country              |    US
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    Telephone            |    918-667-9967
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    Fax                  |    918-667-3387
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Provider Business Mailing Address
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    Address Line         |    PO BOX 295 
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    City                 |    BOLEY
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    State                |    OK
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    Zip                  |    74829-0295
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    Country              |    US
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    Telephone            |    918-667-9967
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    Fax                  |    918-667-3387
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    3598
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    License Number State |    OK
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