Provider Demographics
NPI:1477877835
Name:JAN BIERNE, INC.
Entity Type:Organization
Organization Name:JAN BIERNE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROMA
Authorized Official - Middle Name:JANICE
Authorized Official - Last Name:BIERNE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-737-1132
Mailing Address - Street 1:2912 SOUTH DOUGLAS BLVD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130
Mailing Address - Country:US
Mailing Address - Phone:405-737-1132
Mailing Address - Fax:405-737-1112
Practice Address - Street 1:2912 S. DOUGLAS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130
Practice Address - Country:US
Practice Address - Phone:405-737-1132
Practice Address - Fax:405-737-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty