Provider Demographics
NPI:1770860793
Name:JONES, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:JONES
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 1:8904 N.E 45TH ST.
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084
Mailing Address - Country:US
Mailing Address - Phone:405-249-6145
Mailing Address - Fax:
Practice Address - Street 1:8904 N.E 45TH ST.
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084
Practice Address - Country:US
Practice Address - Phone:405-249-6145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor