Healthcare Provider Details

I. General information

NPI: 1740699685
Provider Name (Legal Business Name): JENNA PARSONS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14001 MCAULEY BLVD STE 240
OKLAHOMA CITY OK
73134-7006
US

IV. Provider business mailing address

1100 LAUREL CREEK DR
YUKON OK
73099-5832
US

V. Phone/Fax

Practice location:
  • Phone: 405-250-6890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4785
License Number StateOK

VIII. Authorized Official

Name: JENNA PARSONS
Title or Position: OWNER/CLINICIAN
Credential: M.A., LPC
Phone: 405-250-6890