Individual
MIA KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7908 NW 23RD ST, BETHANY, OK 73008-4950
(405) 440-1006
Mailing address
10613 LONGVIEW DR, OKLAHOMA CITY, OK 73162-4034
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7689
OK
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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