Individual
MRS. KENNA MARIE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2208 CLUB HOUSE DR, WEATHERFORD, OK 73096-6200
(580) 373-7609
Mailing address
2208 CLUB HOUSE DR, WEATHERFORD, OK 73096-6200
(580) 373-7609
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3631
OK
Other
Enumeration date
02/06/2010
Last updated
03/28/2026
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