Kellie Odeneal is a Peer Specialist based in Wagoner, OK. Kellie Odeneal practices in Wagoner, OK. The NPI Number for Kellie Odeneal is 1720707532 and holds a License No. (Oklahoma).
The current practice location address for Kellie Odeneal is 907 Nw 5Th St, Wagoner, OK and can be reached out via phone at 918-777-1241.
Location: 907 Nw 5Th St, Wagoner, OK, 74467-3103
Provider Profile Details
NPI Number
1720707532
Provider Name
Kellie Odeneal
Credential
Provider Entity Type
Individual
Gender
Female
Address
907 Nw 5Th St, Wagoner, OK, 74467-3103
Phone Number
918-777-1241
Fax Number
Provider Enumeration Date
08/24/2022
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
907 Nw 5Th St
City
State
Zip
74467-3103
Phone Number
918-777-1241
Fax Number
Provider Business Mailing Address Details
Address
907 Nw 5Th St
City
State
Zip
74467-3103
Phone Number
918-777-1241
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
()
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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