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Individual

JESSICA LYNN HERNING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MHR, LPC

Contact information

Practice address
424 S EASTERN AVE, MOORE, OK 73160-5942
(405) 794-1591
Mailing address
3184 ROCK CREEK TRL APT 1103, NORMAN, OK 73072-2524

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6950
OK
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200675060
OK
Enumeration date
07/19/2016
Last updated
06/21/2022
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