Individual
HEATHER HENNESSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 SW A AVE, LAWTON, OK 73501-3821
(580) 357-6889
Mailing address
4723 SE SUNNYMEADE DR, LAWTON, OK 73501-6427
(580) 341-0928
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
11/09/2013
Last updated
11/09/2013
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