Provider Demographics
NPI:1689990582
Name:RING-MILLER, KATHERINE ROSE (LADC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ROSE
Last Name:RING-MILLER
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:ROSE
Other - Last Name:RING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LADC
Mailing Address - Street 1:304 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-2420
Mailing Address - Country:US
Mailing Address - Phone:405-213-2822
Mailing Address - Fax:405-213-2822
Practice Address - Street 1:304 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-2420
Practice Address - Country:US
Practice Address - Phone:405-213-2822
Practice Address - Fax:405-213-2822
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK#499101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor