Individual
JENNA LYNN LOUDAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 N 11TH ST, FREDERICK, OK 73542-2035
(580) 471-1674
Mailing address
1237 E RIDGECREST RD, ALTUS, OK 73521-6901
(580) 471-1674
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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