Individual
JENNA BULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1737 LINWOOD BLVD, OKLAHOMA CITY, OK 73106-5033
(405) 706-8808
Mailing address
9508 NW 89TH ST, YUKON, OK 73099-9308
(405) 535-1556
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/23/2021
Last updated
08/23/2024
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