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Kirk Hodari Russell, BHRS
Mental Health Counselor in Ardmore, Oklahoma
NPI 1215219720

Kirk Hodari Russell is a Mental Health Counselor based in Ardmore, OK and is specialized in Mental Health. Kirk Hodari Russell practices in Ardmore, OK and has the professional credentials of BHRS. The NPI Number for Kirk Hodari Russell is 1215219720 and holds a License No. (Oklahoma).

The current practice location address for Kirk Hodari Russell is 32 N Washington St, Ardmore, OK and can be reached out via phone at 580-226-5209 and via fax at 580-226-5219.

Location: 32 N Washington St, Ardmore, OK, 73401-8075
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215219720
Provider Name
Kirk Hodari Russell
Credential
BHRS
Provider Entity Type
Individual
Gender
Male
Address
32 N Washington St, Ardmore, OK, 73401-8075
Phone Number
580-226-5209
Fax Number
580-226-5219
Provider Enumeration Date
09/12/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200049040 05 OK
institution
Provider Business Practice Location Address Details
Address
32 N Washington St
City
Ardmore
State
Oklahoma
Zip
73401-7013
Phone Number
580-226-5209
Fax Number
580-226-5219
person
Provider Business Mailing Address Details
Address
32 N Washington St
City
Ardmore
State
Oklahoma
Zip
73401-7013
Phone Number
580-226-5209
Fax Number
580-226-5219
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
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Definition
Definition to come...
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