Individual
JENNIFER MARIE HERZBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3080 W 3RD ST, ELK CITY, OK 73644-4323
(580) 225-5136
Mailing address
4400 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5108
(580) 225-5136
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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