Individual
JENNIFER LUCAS BRUSICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
5212 E 69TH PL, TULSA, OK 74136-3407
(918) 280-0101
Mailing address
5212 E 69TH PL, TULSA, OK 74136-3407
(918) 280-0101
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1246
OK
Other
Enumeration date
10/22/2015
Last updated
11/21/2019
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