Individual
DANA CLARK-JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N 5TH ST, HUGO, OK 74743-4005
(580) 326-9475
(580) 326-9028
Mailing address
1603 SLIM RD, VALLIANT, OK 74764-5142
(580) 212-7896
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111200A
—
OK
Enumeration date
07/03/2013
Last updated
02/28/2014
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