Cimarron Psychological Services | |
62620 E 58 Rd Jennings OK 74038-5444 | |
(918) 757-2919 | |
Not Available |
Full Name | Cimarron Psychological Services |
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Speciality | Psychologist - Clinical |
Location | 62620 E 58 Rd, Jennings, Oklahoma |
Authorized Official Name and Position | Christine Ashley Ballenger (PRESIDENT-CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 9187572919 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cimarron Psychological Services 62620 E 58 Rd Jennings OK 74038-5444 Ph: (918) 757-2919 | Cimarron Psychological Services 62620 E 58 Rd Jennings OK 74038-5444 Ph: (918) 757-2919 |
NPI Number | 1447512009 |
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Provider Enumeration Date | 06/11/2012 |
Last Update Date | 06/11/2012 |
Identifier | Type | State | Issuer |
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1447512009 | NPI | - | NPPES |
200133910A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 1063 (Oklahoma) | Primary |