Provider Demographics
NPI:1073826087
Name:KRESSEL, ZONZUREA (MBS, LPC-SUPERVISOR)
Entity type:Individual
Prefix:MS
First Name:ZONZUREA
Middle Name:
Last Name:KRESSEL
Suffix:
Gender:F
Credentials:MBS, LPC-SUPERVISOR
Other - Prefix:
Other - First Name:ZONZUREA
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBS, LPC SUPERVISOR
Mailing Address - Street 1:2608 W. KENOSHA PMB 443
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012
Mailing Address - Country:US
Mailing Address - Phone:918-380-1427
Mailing Address - Fax:
Practice Address - Street 1:2608 W KENOSHA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-8952
Practice Address - Country:US
Practice Address - Phone:918-380-1427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200365720Medicaid