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Individual

MRS. JENNY LEAH GUAJARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED., LPC

Contact information

Practice address
601 N RANDALL AVE, ELK CITY, OK 73644-3345
(580) 243-9218
(844) 270-5692
Mailing address
601 N RANDALL AVE, ELK CITY, OK 73644-3345
(580) 243-9218
(580) 303-7977

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4536
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200400490A
OK
Enumeration date
01/19/2010
Last updated
08/10/2021
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