Individual
JAIMIE PRYOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCP, LPC-S, LADC
Contact information
Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
(580) 215-5765
Mailing address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
(580) 215-5765
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/12/2013
Last updated
06/10/2019
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