Individual
LARA JERNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 W CHICKASHA AVE, SUITE 1, CHICKASHA, OK 73018-2690
(405) 222-3018
Mailing address
205 W CHICKASHA AVE, SUITE 1, CHICKASHA, OK 73018-2690
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
OK
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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