Individual
MISTY DAWN JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7908 NW 23RD ST, BETHANY, OK 73008-4950
(405) 440-1006
(405) 440-1007
Mailing address
7908 NW 23RD ST, BETHANY, OK 73008-4950
(405) 440-1006
(405) 440-1007
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3061
OK
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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