Provider Demographics
NPI:1821318783
Name:NJENJE, BLESSING
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:
Last Name:NJENJE
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 1:1933 NAPA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2985
Mailing Address - Country:US
Mailing Address - Phone:405-819-5553
Mailing Address - Fax:
Practice Address - Street 1:628 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160
Practice Address - Country:US
Practice Address - Phone:405-341-3736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OKR0064269163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation