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Individual

JEANINE RIDENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3839 S BOULEVARD STE 200, EDMOND, OK 73013-5495
(405) 326-1772
(405) 242-5071
Mailing address
3839 S BOULEVARD STE 200, EDMOND, OK 73013-5495
(405) 326-1772

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200815310A
OK
Enumeration date
01/29/2019
Last updated
09/10/2022
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