Provider Demographics
NPI:1205255007
Name:PRESCOTT, JERRI MORINE
Entity type:Individual
Prefix:MS
First Name:JERRI
Middle Name:MORINE
Last Name:PRESCOTT
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 1:17505 MILLER LN
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:OK
Mailing Address - Zip Code:74940-3011
Mailing Address - Country:US
Mailing Address - Phone:918-647-7519
Mailing Address - Fax:
Practice Address - Street 1:17505 MILLER LN
Practice Address - Street 2:
Practice Address - City:HOWE
Practice Address - State:OK
Practice Address - Zip Code:74940-3011
Practice Address - Country:US
Practice Address - Phone:918-647-7519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor