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General NPI Number Information
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NPI Number | 1427307594
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Entity Type | Individual
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Provider Name | JENNA MICHELLE PLUMLEY
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Gender | Female
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 500 N MERIDIAN AVE STE 408
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-5774
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Country | US
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Telephone | 580-716-4878
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 235
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City | RED ROCK
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State | OK
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Zip | 74651-0235
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Country | US
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Telephone | 580-716-4878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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