Provider Demographics
NPI:1396939740
Name:JENNINGS, AARON M (PHD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:M
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 SW 99TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7064
Mailing Address - Country:US
Mailing Address - Phone:580-264-1984
Mailing Address - Fax:
Practice Address - Street 1:7917 MID AMERICA BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135
Practice Address - Country:US
Practice Address - Phone:405-855-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1297103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical