Provider Demographics
NPI:1124230222
Name:CRAIG, JESSICA S (MSW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:S
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 1-240 SERVICE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-7701
Mailing Address - Country:US
Mailing Address - Phone:405-604-9644
Mailing Address - Fax:405-604-9689
Practice Address - Street 1:301 W I-240
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-7701
Practice Address - Country:US
Practice Address - Phone:405-604-9644
Practice Address - Fax:405-604-9689
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor