Basic Information
| Provider Information | |||||||||
| NPI: | 1003279746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRESLEY | ||||||||
| FirstName: | JENI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.A. LPC CANDIDATE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 E MAIN | ||||||||
| Address2: | RESOURCE MANAGEMENT | ||||||||
| City: | ADA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 74820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5804367211 | ||||||||
| FaxNumber: | 5802725757 | ||||||||
| Practice Location | |||||||||
| Address1: | OUTPATIENT SERVICES-ARDMORE; 2510 CHICKASAW DR. | ||||||||
| Address2: | STRONG FAMILY DEVELOPMENT; | ||||||||
| City: | ARDMORE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802268181 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2016 | ||||||||
| LastUpdateDate: | 11/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 2595 | OK | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.