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Individual

JENA L FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5110 S YALE AVE, TULSA, OK 74135-7401
(918) 492-2386
Mailing address
5110 S YALE AVE, TULSA, OK 74135-7401
(918) 492-2386

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3988
OK
235Z00000X
Speech-Language Pathologist
8828
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200511660A
OK
Enumeration date
03/13/2012
Last updated
11/18/2013
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