Provider Demographics
NPI:1447578745
Name:JAGER, LESLIE GAIL (PSRS)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:GAIL
Last Name:JAGER
Suffix:
Gender:F
Credentials:PSRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-3828
Mailing Address - Country:US
Mailing Address - Phone:580-234-8000
Mailing Address - Fax:
Practice Address - Street 1:502 W RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3828
Practice Address - Country:US
Practice Address - Phone:580-234-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor