Individual
JENNIFER M. WALENCIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
1605 BLACKARD LN, PONCA CITY, OK 74604-3508
(580) 304-9767
Mailing address
1605 BLACKARD LN, PONCA CITY, OK 74604-3508
(580) 304-9767
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA105
OK
Other
Enumeration date
10/21/2019
Last updated
04/03/2023
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