Provider Demographics
NPI:1194962613
Name:PATTERSON, JENNIFER L (MS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 NW 122ND ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1957
Mailing Address - Country:US
Mailing Address - Phone:405-532-7575
Mailing Address - Fax:405-242-5345
Practice Address - Street 1:2932 NW 122ND ST
Practice Address - Street 2:SUITE 10
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-1957
Practice Address - Country:US
Practice Address - Phone:405-532-7575
Practice Address - Fax:405-242-5345
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist