Provider Demographics
NPI:1093015380
Name:RONDA J. KIEFER, PLLC
Entity Type:Organization
Organization Name:RONDA J. KIEFER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-834-0104
Mailing Address - Street 1:2805 BLUE QUAIL PASS
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8845
Mailing Address - Country:US
Mailing Address - Phone:405-834-0104
Mailing Address - Fax:405-608-6256
Practice Address - Street 1:3240 W BRITTON RD STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2040
Practice Address - Country:US
Practice Address - Phone:405-834-0104
Practice Address - Fax:405-608-6256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4308101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty