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Search › Oklahoma › 101Y00000X

Destiny Kennedy

NPI 1497506455 · on the registry since 2024 · sole proprietor

Practice

Address
109 S Harrill Ave
Wagoner, OK 74467
Phone
(918) 485-0242
Fax
(918) 485-0204
Organisation at this address
Eagle Ridge Institute
Eagle Ridge Institute
Creoks Mental Health Services
Creoks Mental Health Services, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
97

Registry record

Primary taxonomy
101Y00000X
101Y00000X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-03-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma