| Krystal Easter Ms, Lpc | |
|
2201 Oakridge Dr Tahlequah OK 74464 | |
| (918) 216-9664 | |
| Not Available |
| Full Name | Krystal Easter Ms, Lpc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2201 Oakridge Dr, Tahlequah, Oklahoma |
| Authorized Official Name and Position | Krystal Nichole Vasquez (OWNER/THERAPIST) |
| Authorized Official Contact | 4796592288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Krystal Easter Ms, Lpc 2201 Oakridge Dr Tahlequah OK 74464 Ph: (479) 659-2288 | Krystal Easter Ms, Lpc 2201 Oakridge Dr Tahlequah OK 74464 Ph: (918) 216-9664 |
| NPI Number | 1922549690 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 07/21/2020 |
| Certification Date | 07/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922549690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 6089 (Oklahoma) | Primary |
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