Provider Demographics
NPI:1639498009
Name:PRIVETTE, JATONNA SUE (MA, MS)
Entity Type:Individual
Prefix:MS
First Name:JATONNA
Middle Name:SUE
Last Name:PRIVETTE
Suffix:
Gender:F
Credentials:MA, MS
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Mailing Address - Street 1:623 STONEPOINT DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-7270
Mailing Address - Country:US
Mailing Address - Phone:405-990-3638
Mailing Address - Fax:405-242-3001
Practice Address - Street 1:4334 NW EXPRESSWAY STE 252
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1576
Practice Address - Country:US
Practice Address - Phone:405-810-5373
Practice Address - Fax:405-242-3001
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst