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Individual

MISS JENIECE ANN BRIDGFORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC- CANDIDATE

Contact information

Practice address
12617 S MCLOUD RD, MCLOUD, OK 74851-8509
(405) 481-4755
Mailing address
12617 S MCLOUD RD, MCLOUD, OK 74851-8509
(405) 481-4755

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor
Primary
13313
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100742400 B
OK
05
100742400F
OK
Enumeration date
05/16/2008
Last updated
03/23/2026
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