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Individual

JENNIFER LEA COUCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4130 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5209
(405) 476-5515
Mailing address
4130 LINCOLN BLVD, OKLAHOMA CITY, OK 73105
(405) 476-5515

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
04/18/2016
Last updated
04/18/2016
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