Provider Demographics
NPI:1376028985
Name:TITAMOHKUMI, KUNA M (LPC CANDITATE)
Entity Type:Individual
Prefix:MRS
First Name:KUNA
Middle Name:M
Last Name:TITAMOHKUMI
Suffix:
Gender:F
Credentials:LPC CANDITATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3112 VIA ESPERANZA
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8914
Mailing Address - Country:US
Mailing Address - Phone:140-525-2328
Mailing Address - Fax:
Practice Address - Street 1:4211 NW 23RD ST STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2653
Practice Address - Country:US
Practice Address - Phone:405-606-2528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK$$$$$$$$$Medicaid