Provider Demographics
NPI:1356912471
Name:JARRETT, KARLA (LADC-MH CANDIDATE)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:JARRETT
Suffix:
Gender:F
Credentials:LADC-MH CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 N ANN ARBOR AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73122-2320
Mailing Address - Country:US
Mailing Address - Phone:405-937-4053
Mailing Address - Fax:
Practice Address - Street 1:3824 N ANN ARBOR AVE APT 8
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73122-2320
Practice Address - Country:US
Practice Address - Phone:405-937-4053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKCANDIDATEOtherPRIVATE PRACTICE