| Krista M Doll Llc | |
|
4816 Sw 129th St Oklahoma City OK 73173-8917 | |
| (405) 641-1084 | |
| Not Available |
| Full Name | Krista M Doll Llc |
|---|---|
| Speciality | Counselor |
| Location | 4816 Sw 129th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Krista Doll (OWNER) |
| Authorized Official Contact | 4056411084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Krista M Doll Llc 4816 Sw 129th St Oklahoma City OK 73173-8917 Ph: (405) 641-1084 | Krista M Doll Llc 4816 Sw 129th St Oklahoma City OK 73173-8917 Ph: (405) 641-1084 |
| NPI Number | 1053851543 |
|---|---|
| Provider Enumeration Date | 03/02/2017 |
| Last Update Date | 03/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053851543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6192 (Oklahoma) | Secondary |
| 101YP2500X | Counselor - Professional | 6192 (Oklahoma) | Secondary |
| 101Y00000X | Counselor | 6192 (Oklahoma) | Primary |
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