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Organization

KENDRA BURNSIDE LCSW INC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KENDRA BURNSIDE LCSW (LCSW)
(580) 436-7120
Entity
Organization

Contact information

Practice address
2100 N BROADWAY AVE, ADA, OK 74820-1048
(580) 436-7120
(580) 436-7121
Mailing address
2100 N BROADWAY AVE, ADA, OK 74820-1048
(580) 436-7120
(580) 436-7121

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW
OK

Other

Enumeration date
09/12/2008
Last updated
09/12/2008
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