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Katie Janelle Brister
Mental Health Counselor in Tishomingo, Oklahoma
NPI 1598044828

Katie Janelle Brister is a Mental Health Counselor based in Tishomingo, OK and is specialized in Mental Health. Katie Janelle Brister practices in Tishomingo, OK. The NPI Number for Katie Janelle Brister is 1598044828 and holds a License No. (Oklahoma).

The current practice location address for Katie Janelle Brister is 504 E 24Th St, Tishomingo, OK and can be reached out via phone at 903-815-0843.

Location: 504 E 24Th St, Tishomingo, OK, 73460-3214
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598044828
Provider Name
Katie Janelle Brister
Credential
Provider Entity Type
Individual
Gender
Female
Address
504 E 24Th St, Tishomingo, OK, 73460-3214
Phone Number
903-815-0843
Fax Number
Provider Enumeration Date
08/04/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100746580E 05 OK
institution
Provider Business Practice Location Address Details
Address
504 E 24Th St
City
Tishomingo
State
Oklahoma
Zip
73460-3214
Phone Number
903-815-0843
Fax Number
person
Provider Business Mailing Address Details
Address
504 E 24Th St
City
Tishomingo
State
Oklahoma
Zip
73460-3214
Phone Number
903-815-0843
Fax Number
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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