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Individual

KATELYN CHEYANNE CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
316 W MAIN ST, HENRYETTA, OK 74437-4240
(918) 650-9292
Mailing address
316 W MAIN ST, HENRYETTA, OK 74437-4240
(918) 650-9292

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
08/17/2020
Last updated
08/17/2020
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