Individual
BRENDEN JESUS RAIZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
10401 GREENBRIAR PKWY, OKLAHOMA CITY, OK 73159-7662
(580) 650-8249
Mailing address
9733 SW 24TH TER, OKLAHOMA CITY, OK 73128-1900
(580) 650-8249
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC12221
OK
101Y00000X
Counselor
Primary
LPCCANDIDATE12221
OK
Other
Enumeration date
06/03/2024
Last updated
02/11/2026
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