Bridgforth, Jeniece Ann
Bridgforth, Jeniece Ann is an individual health care provider with primary practice located at 2701 N Oklahoma Ave , Oklahoma City OK 73105-2724. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Bridgforth, Jeniece Ann can be contacted via phone (405) 528-8686.Contact Information
Primary practice address
2701 N Oklahoma Ave
Oklahoma City OK 73105-2724
Phone: (405) 528-8686
Fax: (405) 528-8692
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1669639720 |
|---|---|
| LBN Legal business name | Bridgforth, Jeniece Ann |
| Credentials | CADC UNDERSUPERVISIO |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2008 |
| Last updated | May 16th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669639720 | NPPES |
| Oklahoma | MEDICAID | 100742400F | |
| Oklahoma | MEDICAID | 100742400 B |
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