Individual
MRS. AMANDA LYNN FENNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
214 YUKON AVE, YUKON, OK 73099-4535
(405) 215-4379
Mailing address
214 YUKON AVE, YUKON, OK 73099-4535
(405) 215-4379
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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