Individual
VIRGINIA PEMBERTON PATTON KINKADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
124 E MAIN ST SUITE 2, THE CHICKASAW NATION DEPT OF FAMILY SERVICES, ADA, OK 74820
(580) 310-7993
(405) 878-4708
Mailing address
210 E MAIN ST, RESOURCE MANAGEMENT, ADA, OK 74820
(580) 436-7211
(580) 272-5757
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
OK
1041C0700X
Clinical Social Worker
Primary
4854
OK
Other
Enumeration date
08/18/2009
Last updated
07/21/2022
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