Individual
PRINCESS DANIELLE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2225 N UNION ST, PONCA CITY, OK 74601-1555
(580) 401-3483
Mailing address
600 N LAKE ST, PONCA CITY, OK 74601-3941
(580) 401-3483
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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