Provider Demographics
NPI:1326378407
Name:HARPER, JOCELYN RE'
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:RE'
Last Name:HARPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14814 E 74TH ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-6060
Mailing Address - Country:US
Mailing Address - Phone:405-762-6016
Mailing Address - Fax:
Practice Address - Street 1:126 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:PERKINS
Practice Address - State:OK
Practice Address - Zip Code:74059-7942
Practice Address - Country:US
Practice Address - Phone:405-939-3701
Practice Address - Fax:405-939-1024
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health