MISS Keni Deatherage, BA, BHRS

NPI #1962787580 in Heavener, Oklahoma

Provider Information

NPI Number
1962787580
Entity Type
Individual
Name
MISS Keni Deatherage, BA, BHRS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Psychologist - Rehabilitation
Credential
BA, BHRS
Enumeration Date
Oct 14, 2011
Last Updated
Oct 14, 2011

Practice Location

Address
1005 CORONET CIR
ZIP Code
74937-3806
Phone
(479) 462-9818

Specialties & Taxonomy Codes

Specialty
Psychologist - RehabilitationRehabilitation

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