Individual
JESSICA CONN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4130 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5209
(405) 424-7711
Mailing address
813 RYAN RD, MOORE, OK 73160-6089
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
21073-P
OK
Other
Enumeration date
09/02/2022
Last updated
07/29/2024
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