Provider Demographics
NPI:1831696269
Name:JESSICA L. PLUMLEY, PH.D. PLLC
Entity type:Organization
Organization Name:JESSICA L. PLUMLEY, PH.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-922-1867
Mailing Address - Street 1:1801 W WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73116-4115
Mailing Address - Country:US
Mailing Address - Phone:405-922-1867
Mailing Address - Fax:
Practice Address - Street 1:1300 E 9TH ST STE 5
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-5760
Practice Address - Country:US
Practice Address - Phone:405-529-6065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)