Individual
AMBER KAITLIN KENISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8787 N OWASSO EXPY STE E, OWASSO, OK 74055-4482
(918) 516-2211
Mailing address
304044 E 1612 RD, FOSTER, OK 73434
(845) 518-7094
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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