Provider Demographics
NPI:1083022909
Name:WENDY TUNNESSEN
Entity Type:Organization
Organization Name:WENDY TUNNESSEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TUNNESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT CANDIDATE
Authorized Official - Phone:580-875-3288
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:RANDLETT
Mailing Address - State:OK
Mailing Address - Zip Code:73562-0021
Mailing Address - Country:US
Mailing Address - Phone:580-878-5328
Mailing Address - Fax:
Practice Address - Street 1:420 E WYOMING ST
Practice Address - Street 2:
Practice Address - City:WALTERS
Practice Address - State:OK
Practice Address - Zip Code:73572-2862
Practice Address - Country:US
Practice Address - Phone:580-875-3288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health