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Individual

JENNY ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
30 C ST NE, MIAMI, OK 74354-6316
(918) 540-1563
(915) 542-7778
Mailing address
30 C ST NE, MIAMI, OK 74354-6316
(918) 540-1563
(918) 542-7778

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4988
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100732380C
OK
Enumeration date
05/03/2007
Last updated
10/14/2014
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