Individual
JENI PITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1219 K ST NW, ARDMORE, OK 73401-1801
(580) 798-4523
(580) 319-5349
Mailing address
PO BOX 427, ARDMORE, OK 73402-0427
(580) 798-4523
(580) 319-5349
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830
—
OK
Enumeration date
11/17/2015
Last updated
11/17/2015
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