Healthcare Provider Details

I. General information

NPI: 1366798423
Provider Name (Legal Business Name): JESSICA CLOYED LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2012
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 SW 30TH CT STE B
MOORE OK
73160-2888
US

IV. Provider business mailing address

1108 SW 30TH CT STE B
MOORE OK
73160-2888
US

V. Phone/Fax

Practice location:
  • Phone: 405-378-2727
  • Fax:
Mailing address:
  • Phone: 405-378-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT01254
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: