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Individual

KENDRA LEA LASSLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BE

Contact information

Practice address
9210 SOUTH WESTERN AVE, A 21, OKLAHOMA CITY, OK 73139-8605
(405) 626-1711
(405) 892-7544
Mailing address
1920 EAST CRAZY HORSE AVE, STILLWATER, OK 74075-5417
(918) 225-9428

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
174400000X
Specialist

Other

Enumeration date
09/11/2012
Last updated
12/11/2013
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