Provider Demographics
NPI:1942580998
Name:VERBA, KATHLEEN M
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:VERBA
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 1:7010 S YALE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-5713
Mailing Address - Country:US
Mailing Address - Phone:918-492-2554
Mailing Address - Fax:
Practice Address - Street 1:7010 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5713
Practice Address - Country:US
Practice Address - Phone:918-492-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor