Provider Demographics
NPI:1487879136
Name:GUALNAM, THANGKHAN K (LPC)
Entity type:Individual
Prefix:
First Name:THANGKHAN
Middle Name:K
Last Name:GUALNAM
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 E 81ST ST STE 4460
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4251
Mailing Address - Country:US
Mailing Address - Phone:918-600-2966
Mailing Address - Fax:
Practice Address - Street 1:2448 E 81ST ST STE 4460
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4251
Practice Address - Country:US
Practice Address - Phone:918-600-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional