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General NPI Number Information
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NPI Number | 1427397041
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Entity Type | Individual
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Provider Name | JAMIE ROLLER MCP, LPC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 2023 TURNER ST
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City | PONCA CITY
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State | OK
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Zip | 74604-2733
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Country | US
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Telephone | 580-761-4227
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Fax |
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Provider Business Mailing Address
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Address Line | 2023 TURNER
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City | PONCA CITY
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State | OK
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Zip | 74604
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Country | US
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Telephone | 580-716-3851
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Fax | 580-298-5357
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5901
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License Number State | OK
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