| Cimarron Psychological Services | |
|
62620 E 58 Rd Jennings OK 74038-5444 | |
| (918) 757-2919 | |
| Not Available |
| Full Name | Cimarron Psychological Services |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 62620 E 58 Rd, Jennings, Oklahoma |
| Authorized Official Name and Position | Christine Ashley Ballenger (PRESIDENT-CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9187572919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cimarron Psychological Services 62620 E 58 Rd Jennings OK 74038-5444 Ph: (918) 757-2919 | Cimarron Psychological Services 62620 E 58 Rd Jennings OK 74038-5444 Ph: (918) 757-2919 |
| NPI Number | 1447512009 |
|---|---|
| Provider Enumeration Date | 06/11/2012 |
| Last Update Date | 06/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447512009 | NPI | - | NPPES |
| 200133910A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1063 (Oklahoma) | Primary |