Kickapoo Health Center

NPI #1407128572 in Mcloud, Oklahoma

Provider Information

NPI Number: 1407128572
Entity Type: Organization
Organization Name: Kickapoo Health Center
Primary Specialty: Counselor
Enumeration Date: Feb 3, 2012
Last Updated: Feb 3, 2012

Practice Location

Address: 105365 S.HIGHWAY 102
City: Mcloud
State: Oklahoma
ZIP Code: 74851
Phone: (405) 964-2618

Authorized Official

Name: CHRISTINE S. MCKINNEY, BACHELORS DEGREE
Title: CASE MANAGER
Phone: (405) 964-2618

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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