Individual
JESSICA LEANNA LAJUAN TROTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1336 N HARRISON AVE, SHAWNEE, OK 74801-5206
(405) 424-7711
Mailing address
3101 NW 150TH ST APT 24B, OKLAHOMA CITY, OK 73134-2021
(405) 881-5565
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103K00000X
—
OK
Enumeration date
08/25/2010
Last updated
06/27/2023
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