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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MISS KENI DEATHERAGE, BA, BHRS

Active Sole Proprietor

MISS KENI DEATHERAGE, BA, BHRS is a Rehabilitation Psychologist healthcare provider located in HEAVENER, Oklahoma. NPI 1962787580 is currently active in the NPPES registry. Verify at CMS.

Rehabilitation Psychologist · HEAVENER, OK

Registration Details

NPI Number
1962787580
Provider Type
Individual
Gender
Female
NPI Issued
Oct 14, 2011 (14.861554859307 yrs)
Last Updated
Oct 14, 2011
Sole Proprietor
Yes

Practice Information

Address
1005 CORONET CIR
HEAVENER, OK, 749373806
Browse OK providers · Browse ZIP 74937
Phone
4794629818
Primary Specialty
Rehabilitation Psychologist
103TR0400X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.