Provider Demographics
NPI:1932482999
Name:KENDRICK, REBECCA A (MS, LPC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:MS, LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 NW CACHE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5258
Mailing Address - Country:US
Mailing Address - Phone:580-351-9998
Mailing Address - Fax:580-351-9898
Practice Address - Street 1:2215 NW CACHE RD STE 107
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5258
Practice Address - Country:US
Practice Address - Phone:580-351-9998
Practice Address - Fax:580-351-9898
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health