Most Relevant Information
Provider Data
| NPI Number: | 1003269838 |
| Provider Name: | JENNIFER BLACK |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/17/2016 |
| Last Updated: | 07/18/2016 |
Provider Practice Location
2325 S HARVARD AVE
TULSA
OK
741143300
Practice Location Phone/Fax
| Phone: | 9187124301 |
| Fax: | 9185601399 |
Provider Mailing Location
650 S PEORIA AVE
TULSA
OK
741204429
Provider Mailing Phone/Fax
| Phone: | 9185879471 |
| Fax: | 9185601399 |