Individual
MISS JEANETTE LOUDERMILK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3816 OAK VALLEY RD, OKLAHOMA CITY, OK 73135-2055
(405) 818-8489
Mailing address
PO BOX 36434, OKLAHOMA CITY, OK 73136-2434
(405) 818-8489
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5120
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
5120
OK
101YM0800X
Mental Health Counselor
Primary
5120
OK
101YP2500X
Professional Counselor
5120
OK
106H00000X
Marriage & Family Therapist
5120
OK
Other
Enumeration date
06/23/2011
Last updated
08/07/2013
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