Provider Information for 1316228315
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JULIE KLINE LCSW
Sex: Female
NPI: 1316228315
Last Updated: 2011-09-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1316228315 | ||||||||||||
| Enumeration Date | 2011-09-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1103 W EDGEWATER ST BROKEN ARROW, OK 74012-7630 United States Phone: 918-810-5779 | Fax: | ||||||||||||
| Primary Practice Address | 724 S MISSION ST SAPULPA, OK 74066-4660 United States Phone: 918-248-4340 | Fax: | ||||||||||||
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