| Doctor Name: | MRS. DANIELLE CHARLOTTE MARIE HOLMSTROM |
| NPI Number: | 1114264397 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 5797 |
| Business Practice Address: | 14625 Ne 23rd St Choctaw, OK - 730208728 |
| Business Phone Number: | 4053908131 |
| Business Fax Number: | |
| Mailing Address: | 2433 Sw 54th St, OKLAHOMA CITY |
| State: | OK |
| Postal Code: | 731196019 |
| Phone Number: | 4055327608 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2013 |
| NPI Last Update Date: | 02/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 5797 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |