Individual
MRS. JENNIFER B ELISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., L.B.P.
Contact information
Practice address
203 E MAIN ST, MADILL, OK 73446-2240
(405) 300-8588
Mailing address
PO BOX 14354, OKLAHOMA CITY, OK 73113-0354
(405) 412-9842
(405) 896-9872
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
321
OK
101YP2500X
Professional Counselor
321
OK
Other
Enumeration date
07/13/2009
Last updated
11/20/2025
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