Provider Demographics
NPI:1982096400
Name:WALKER, KRISTIN COLLEEN (MA, LPC, RPT, IMH-E)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:COLLEEN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MA, LPC, RPT, IMH-E
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1498
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74355-1498
Mailing Address - Country:US
Mailing Address - Phone:918-332-4445
Mailing Address - Fax:918-332-4424
Practice Address - Street 1:PO BOX 1498
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74355-1498
Practice Address - Country:US
Practice Address - Phone:918-332-4445
Practice Address - Fax:918-332-4424
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health