Provider Demographics
NPI:1154486470
Name:COX, KIMBERLY ANN (LBP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:COX
Suffix:
Gender:F
Credentials:LBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:RUSH SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:73082-0455
Mailing Address - Country:US
Mailing Address - Phone:405-406-6066
Mailing Address - Fax:
Practice Address - Street 1:215 W LINN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-5837
Practice Address - Country:US
Practice Address - Phone:405-321-0022
Practice Address - Fax:405-360-4918
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLBP 0158101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health