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Kenneth Wayne Dewitt
Peer Specialist in Checotah, Oklahoma
NPI 1982468047

Kenneth Wayne Dewitt is a Peer Specialist based in Checotah, OK. Kenneth Wayne Dewitt practices in Checotah, OK. The NPI Number for Kenneth Wayne Dewitt is 1982468047 and holds a License No. (Oklahoma).

The current practice location address for Kenneth Wayne Dewitt is 417759 East 1116 Rd, Checotah, OK and can be reached out via phone at 405-493-5654.

Location: 417759 East 1116 Rd, Checotah, OK, 74426
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1982468047
Provider Name
Kenneth Wayne Dewitt
Credential
Provider Entity Type
Individual
Gender
Male
Address
417759 East 1116 Rd, Checotah, OK, 74426
Phone Number
405-493-5654
Fax Number
Provider Enumeration Date
02/09/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
417759 East 1116 Rd
City
Checotah
State
Oklahoma
Zip
74426
Phone Number
405-493-5654
Fax Number
person
Provider Business Mailing Address Details
Address
417759 East 1116 Rd
City
Checotah
State
Oklahoma
Zip
74426
Phone Number
405-493-5654
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
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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