Provider Demographics
NPI:1205142205
Name:KIRCHNER, DAWN MARIE (BA, BHRS)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:KIRCHNER
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Gender:F
Credentials:BA, BHRS
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Mailing Address - Street 1:1001 WEST MAIN STREET
Mailing Address - Street 2:MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701
Mailing Address - Country:US
Mailing Address - Phone:580-924-7330
Mailing Address - Fax:580-924-2739
Practice Address - Street 1:1001 WEST MAIN STREET
Practice Address - Street 2:MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701
Practice Address - Country:US
Practice Address - Phone:580-924-7330
Practice Address - Fax:580-924-2739
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKM081325997103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1427104546OtherDEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES