Provider Demographics
NPI:1063761633
Name:GILLS, KAREN LORELLE (BHRS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LORELLE
Last Name:GILLS
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 EAST OKLAHOMA STREET
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106
Mailing Address - Country:US
Mailing Address - Phone:918-855-7456
Mailing Address - Fax:918-340-5189
Practice Address - Street 1:4528 SOUTH SHERIDAN ROAD
Practice Address - Street 2:SUITE 117
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1140
Practice Address - Country:US
Practice Address - Phone:918-794-6570
Practice Address - Fax:918-340-5189
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor