| Kendra Burnside Lcsw Inc Pc | |
|
2100 N Broadway Ave Ada OK 74820-1048 | |
| (580) 436-7120 | |
| (580) 436-7121 |
| Full Name | Kendra Burnside Lcsw Inc Pc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2100 N Broadway Ave, Ada, Oklahoma |
| Authorized Official Name and Position | Kendra Burnside (LCSW) |
| Authorized Official Contact | 5804367120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kendra Burnside Lcsw Inc Pc 2100 N Broadway Ave Ada OK 74820-1048 Ph: (580) 436-7120 | Kendra Burnside Lcsw Inc Pc 2100 N Broadway Ave Ada OK 74820-1048 Ph: (580) 436-7120 |
| NPI Number | 1316196405 |
|---|---|
| Provider Enumeration Date | 09/12/2008 |
| Last Update Date | 09/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316196405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCSW (Oklahoma) | Primary |
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