Organization
EDMONDSON FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ERIN EDMONDSON MA, LPC, LADC, CMIII (LICENSED PROFESSIONAL COUNSELOR)
(405) 315-7093
Entity
Organization
Contact information
Practice address
1015 WATERWOOD PKWY, SUITE G, L-2, EDMOND, OK 73034-5327
(405) 315-7093
Mailing address
1015 WATERWOOD PKWY, SUITE G, L-2, EDMOND, OK 73034-5327
(405) 315-7093
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
1067
OK
251S00000X
Community/Behavioral Health Agency
Primary
5028
OK
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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