Provider Demographics
NPI:1740322437
Name:JURENA, DIANNA
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:JURENA
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 1:2202 E 49TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-8714
Mailing Address - Country:US
Mailing Address - Phone:918-645-7681
Mailing Address - Fax:918-749-1841
Practice Address - Street 1:2202 E 49TH ST STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-8714
Practice Address - Country:US
Practice Address - Phone:918-645-7681
Practice Address - Fax:918-749-1841
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional