Potter, Jennifer Renee

Potter, Jennifer Renee is an individual health care provider with primary practice located at 14453 Se 29Th St Suite D, Choctaw OK 73020-6541. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Potter, Jennifer Renee can be contacted via phone (405) 741-2844.

Contact Information

Primary practice address
14453 Se 29Th St Suite D Choctaw OK 73020-6541
Phone: (405) 741-2844
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1101 Oklahoma

Profile Details

NPI number 1558517649
LBN Legal business name Potter, Jennifer Renee
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2008
Last updated Aug 11th, 2011 - about 15 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1558517649 NPPES
Oklahoma MEDICAID 200226900A

Popular Providers