Individual
MR. KENNETH LYNN GANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
1300 HOPPE BLVD STE 5, ADA, OK 74820-2319
(580) 436-1222
(580) 436-1333
Mailing address
1300 HOPPE BLVD STE 1, ADA, OK 74820-2319
(580) 436-7211
(580) 272-5757
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1738
OK
Other
Enumeration date
07/05/2006
Last updated
09/18/2018
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