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Individual

ANGELA JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3015 E SKELLY DR STE 103, TULSA, OK 74105-6344
(918) 712-0859
(918) 388-9708
Mailing address
1601 OLD SOUTH RIVER RD, SAINT CHARLES, MO 63303-4120
(636) 224-1210
(636) 246-1008

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
7121
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200323940
OK
Enumeration date
08/30/2017
Last updated
07/21/2022
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