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General NPI Number Information
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NPI Number | 1750663464
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Entity Type | Individual
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Provider Name | JENNIFER A ESTERMAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 08/04/2015
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Provider Practice Location Address
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Address Line | 921 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5007
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Country | US
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Telephone | 405-456-5183
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Fax |
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Provider Business Mailing Address
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Address Line | 4702 SE 77TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73135-4543
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Country | US
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Telephone | 513-503-6339
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7045
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License Number State | OH
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