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1902015696
KIM PETERSON
OKLAHOMA CITY, OK
NPI
1902015696
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 117)
Enumeration Date
2007-05-21
Last Update Date
2007-07-08
Business Address
-- KIM PETERSON LADC
1140 N HUDSON AVE
OKLAHOMA CITY, OK 73103-3918
Phone number: 405-272-0660
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Mailing Address
-- KIM PETERSON LADC
4436 NW 50TH ST
OKLAHOMA CITY, OK 73112-2212
Phone number:
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