Provider Demographics
NPI:1619265634
Name:KESTER, LAUREN L
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:L
Last Name:KESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 W CHEROKEE ST STE A
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-4600
Mailing Address - Country:US
Mailing Address - Phone:918-485-2000
Mailing Address - Fax:
Practice Address - Street 1:1102 W CHEROKEE ST STE A
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-4600
Practice Address - Country:US
Practice Address - Phone:918-485-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker