Individual
KENNA CHENNAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 S MADISON AVE STE 24, ELK CITY, OK 73644-5741
(580) 660-5573
Mailing address
PO BOX 21, ROCKY, OK 73661-0021
(405) 210-8281
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/23/2010
Last updated
07/23/2010
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