Individual
LAUREN KENNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
504 W ATLANTA ST, BROKEN ARROW, OK 74012-7004
(918) 615-6620
Mailing address
504 W ATLANTA ST, BROKEN ARROW, OK 74012-7004
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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