Individual
KENNETH REX HEDDLESTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
102 E BROADWAY ST, ANADARKO, OK 73005-2824
(405) 247-9777
(405) 247-9778
Mailing address
102 E BROADWAY ST, ANADARKO, OK 73005-2824
(405) 247-9777
(405) 247-9778
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1961
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1961
LPC NUMBER
OK
Enumeration date
04/23/2007
Last updated
07/08/2007
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