Doctor Name: | MRS. KRISTINA L MCKUNE |
NPI Number: | 1184669780 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, LADC, NCC, ACHT |
License Number: | 2729 |
Business Practice Address: | 118 W Broadway St Ste 102 Altus, OK - 735213816 |
Business Phone Number: | 5803794900 |
Business Fax Number: | 5803794921 |
Mailing Address: | Po Box 112, ELDORADO |
State: | OK |
Postal Code: | 735370112 |
Phone Number: | 5803794900 |
Fax Number: | 5803794921 |
NPI Enumeration Date: | 06/18/2006 |
NPI Last Update Date: | 06/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2729 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |