Most Relevant Information
Provider Data
| NPI Number: | 1003063413 |
| Provider Name: | KACY LEIGH DUVALL MS, LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 5067 |
Most Important Dates
| Enumeration Date: | 08/27/2008 |
| Last Updated: | 02/13/2017 |
Provider Practice Location
1516 S BOSTON AVE
SUITE 1
TULSA
OK
741194003
Practice Location Phone/Fax
| Phone: | 9185616000 |
| Fax: | 9185616001 |
Provider Mailing Location
1516 S BOSTON AVE
SUITE 1
TULSA
OK
741194003
Provider Mailing Phone/Fax
| Phone: | 9185616000 |
| Fax: | 9185616001 |