Individual
RACHIEL ANN ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC UNDERSUPERVISION
Contact information
Practice address
721 S GEORGE NIGH EXPY, MCALESTER, OK 74501-7400
(918) 470-7069
(918) 302-0405
Mailing address
721 S GEORGE NIGH EXPY, MCALESTER, OK 74501-7400
(918) 470-7069
(918) 302-0405
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746580A
—
OK
Enumeration date
01/22/2010
Last updated
01/22/2010
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