Provider Demographics
NPI:1740623537
Name:BAKER, JENNIFER A (MS, LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:BAKER
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SW 104TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7661
Mailing Address - Country:US
Mailing Address - Phone:405-635-3888
Mailing Address - Fax:405-225-3980
Practice Address - Street 1:1500 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7661
Practice Address - Country:US
Practice Address - Phone:405-635-3888
Practice Address - Fax:405-225-3980
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist