Provider Demographics
NPI:1497464929
Name:OFOH, JILL KIMBERLY (LPC, MED)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:KIMBERLY
Last Name:OFOH
Suffix:
Gender:F
Credentials:LPC, MED
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:KIMBERLY
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2609 TUSCARORA TRL
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-8956
Mailing Address - Country:US
Mailing Address - Phone:325-234-5472
Mailing Address - Fax:
Practice Address - Street 1:2609 TUSCARORA TRL
Practice Address - Street 2:
Practice Address - City:GLENN HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:75154-8956
Practice Address - Country:US
Practice Address - Phone:325-234-5472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73989101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional