Provider Demographics
NPI:1972876225
Name:BROWN, JILL ANN (LMFT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:ANN
Other - Last Name:CRAIGHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2217 PINE VIEW TER
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-2475
Mailing Address - Country:US
Mailing Address - Phone:405-206-7383
Mailing Address - Fax:
Practice Address - Street 1:2217 PINE VIEW TER
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-2475
Practice Address - Country:US
Practice Address - Phone:405-206-7383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist