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Kenneth Wayne Patton SR.
Peer Specialist in Broken Arrow, Oklahoma
NPI 1538946512

Kenneth Wayne Patton SR. is a Peer Specialist based in Broken Arrow, OK. Kenneth Wayne Patton SR. practices in Broken Arrow, OK. The NPI Number for Kenneth Wayne Patton SR. is 1538946512 and holds a License No. 2021-889 (Oklahoma).

The current practice location address for Kenneth Wayne Patton SR. is 7323 E Nashville St, Broken Arrow, OK and can be reached out via phone at 918-853-5153.

Location: 7323 E Nashville St, Broken Arrow, OK, 74014-2980
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538946512
Provider Name
Kenneth Wayne Patton SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
7323 E Nashville St, Broken Arrow, OK, 74014-2980
Phone Number
918-853-5153
Fax Number
Provider Enumeration Date
09/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7323 E Nashville St
City
Broken Arrow
State
Oklahoma
Zip
74014-2980
Phone Number
918-853-5153
Fax Number
person
Provider Business Mailing Address Details
Address
7323 E Nashville St
City
Broken Arrow
State
Oklahoma
Zip
74014-2980
Phone Number
918-853-5153
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
2021-889 (Oklahoma)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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