Organization
CIMARRON PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE ASHLEY BALLENGER PSYD (PRESIDENT-CLINICAL PSYCHOLOGIST)
(918) 757-2919
Entity
Organization
Contact information
Practice address
62620 E 58 RD, JENNINGS, OK 74038-5444
(918) 757-2919
Mailing address
62620 E 58 RD, JENNINGS, OK 74038-5444
(918) 757-2919
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1063
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200133910A
—
OK
Enumeration date
06/11/2012
Last updated
06/11/2012
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