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General NPI Number Information
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NPI Number | 1083022909
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Entity Type | Organization
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Legal Business Name | WENDY TUNNESSEN
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 420 E WYOMING ST
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City | WALTERS
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State | OK
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Zip | 73572-2862
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Country | US
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Telephone | 580-875-3288
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21
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City | RANDLETT
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State | OK
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Zip | 73562-0021
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Country | US
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Telephone | 580-878-5328
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | WENDY LYNN TUNNESSEN
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Credential | LMFT CANDIDATE
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Telephone | 580-875-3288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OK
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