Individual
JENNIFER MATLOCK-BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(405) 424-7711
Mailing address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(405) 424-7711
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC04799
OK
101YM0800X
Mental Health Counselor
MHC-607
HI
Other
Enumeration date
01/04/2010
Last updated
09/21/2023
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