Individual
JESSICA TARA DIXON-NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
505 S MAIN ST, PORTER, OK 74454-1015
(918) 483-0111
Mailing address
1450 STONE CREST DR, EDMOND, OK 73034-6605
(918) 734-7797
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10393
OK
Other
Enumeration date
06/21/2021
Last updated
06/19/2023
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