Provider Demographics
NPI:1558993691
Name:HENDRIX, JENNIFER A
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:HENDRIX
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 1:27871 N 3950 RD
Mailing Address - Street 2:
Mailing Address - City:OCHELATA
Mailing Address - State:OK
Mailing Address - Zip Code:74051-2005
Mailing Address - Country:US
Mailing Address - Phone:918-534-6313
Mailing Address - Fax:
Practice Address - Street 1:401 S DEWEY AVE STE 108
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3525
Practice Address - Country:US
Practice Address - Phone:918-336-0810
Practice Address - Fax:918-336-0836
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator