| Jennifer Clark, Psy.d., P.c. | |
|
1225 W Main St Ste 102 Norman OK 73069-6824 | |
| (405) 292-1000 | |
| (405) 801-2506 |
| Full Name | Jennifer Clark, Psy.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1225 W Main St, Norman, Oklahoma |
| Authorized Official Name and Position | Jennifer Clark (OWNER) |
| Authorized Official Contact | 4052921000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Clark, Psy.d., P.c. 1225 W Main St Ste 102 Norman OK 73069-6824 Ph: (405) 292-1000 | Jennifer Clark, Psy.d., P.c. 1225 W Main St Ste 102 Norman OK 73069-6824 Ph: (405) 292-1000 |
| NPI Number | 1972817781 |
|---|---|
| Provider Enumeration Date | 08/04/2010 |
| Last Update Date | 08/04/2010 |
| Medicare PECOS PAC ID | 1052566403 |
|---|---|
| Medicare Enrollment ID | O20130309000075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972817781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1039 (Oklahoma) | Primary |
| Provider Name | Jennifer Clark |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1194855536 PECOS PAC ID: 7315192762 Enrollment ID: I20130309000084 |
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