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NPI Code Detail

MEDICARE: JENNIFER ELIZABETH MUNDE HARDING - YALKA B.A., BHRS, CM, RSS

MEDICARE: JENNIFER ELIZABETH MUNDE HARDING - YALKA B.A., BHRS, CM, RSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1225233950
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ELIZABETH MUNDE HARDING - YALKA B.A., BHRS, CM, RSS
Provider Business Mailing Address
First Line : 1215 NW 25TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-5629
Country : US
Telephone Number : 405-525-2525
Fax Number : 405-524-3549
Provider Business Practice Location Address
First Line : 1215 NW 25TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-5629
Country : US
Telephone Number : 405-525-2525
Fax Number : 405-524-3549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 11/20/2012

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