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1083919179
TERESA WILIE KENNISON
TISHOMINGO, OK
NPI
1083919179
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
103K00000X Behavior Analyst
Enumeration Date
2011-01-20
Last Update Date
2013-04-01
Business Address
-- TERESA WILIE KENNISON MS, LPC-Candidate
1350 S MULDROW ST
TISHOMINGO, OK 73460-3278
Phone number: 580-579-3620
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Mailing Address
-- TERESA WILIE KENNISON MS, LPC-Candidate
1350 S MULDROW ST
TISHOMINGO, OK 73460-3278
Phone number: 580-579-3620
Copy
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