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Individual

MRS. JASMIN RIVAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
921 NE 13TH ST, #122, OKLAHOMA CITY, OK 73104
(405) 456-1000
Mailing address
921 NE 13TH ST, #122, OKLAHOMA CITY, OK 73104
(405) 456-1000

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
5086
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
H081762182
OK
Enumeration date
09/12/2011
Last updated
04/08/2021
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