Provider Demographics
NPI:1881913861
Name:WINSTON, KIMBERLY LASHAUN
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LASHAUN
Last Name:WINSTON
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 1:5009 ABLE ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-2523
Mailing Address - Country:US
Mailing Address - Phone:405-812-9958
Mailing Address - Fax:
Practice Address - Street 1:225 S WARDS CHAPEL
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-4104
Practice Address - Country:US
Practice Address - Phone:580-380-1844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-29
Last Update Date:2010-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor