Individual
KENNEDY NICOLE GOODNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 MEDICAL PKWY, CLAREMORE, OK 74017-1088
(844) 548-2100
Mailing address
3100 MEDICAL PKWY, CLAREMORE, OK 74017-1088
(844) 548-2100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
AR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/16/2022
Last updated
08/07/2023
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