Individual
JENNIFER LEEANN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35859 E.W. 1210, SEMINOLE, OK 74868
(405) 220-6207
Mailing address
712 S WEWOKA AVE, WEWOKA, OK 74884-3243
(405) 683-4136
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/03/2018
Last updated
03/11/2024
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