Miss Keni Deatherage, BA, BHRS - Psychologist in Heavener, OK

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Miss Keni Deatherage, BA, BHRS is a Psychologist - Rehabilitation based in Heavener, Oklahoma. Miss Keni Deatherage is licensed to practice in * (Not Available) (license number ) and her current practice location is 1005 Coronet Cir, Heavener, Oklahoma. She can be reached at her office (for appointments etc.) via phone at (479) 462-9818.

NPI number for Miss Keni Deatherage is 1962787580 and her current mailing address is 1005 Coronet Cir, Heavener, Oklahoma. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1962787580.

Contact Information

Miss Keni Deatherage, BA, BHRS
1005 Coronet Cir,
Heavener, OK 74937-3806
(479) 462-9818
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMiss Keni Deatherage
GenderFemale
SpecialityPsychologist - Rehabilitation
Location1005 Coronet Cir, Heavener, Oklahoma
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1962787580
  • Provider Enumeration Date: 10/14/2011
  • Last Update Date: 10/14/2011

Medical Identifiers

Medical identifiers for Miss Keni Deatherage such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962787580NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TR0400XPsychologist - Rehabilitation (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Keni Deatherage is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Miss Keni Deatherage, BA, BHRS
1005 Coronet Cir,
Heavener, OK 74937-3806

Ph: (479) 462-9818		Miss Keni Deatherage, BA, BHRS
1005 Coronet Cir,
Heavener, OK 74937-3806

Ph: (479) 462-9818

Reviews and Comments


Psychologist in Heavener, OK


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