Jessica Pendergraft
Rehabilitation Psychologist
615 Amy Dr
Waukomis
, Oklahoma 73773-1033
Jessica Pendergraft
Rehabilitation Psychologist
615 Amy Dr
Waukomis
, Oklahoma 73773-1033
(580) 478-5035
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About
Features
Specialties
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Jessica Pendergraft
- 615 Amy Dr Po Box 273
- Waukomis, OK
- Zip : 73773-1033
- Phone : (580) 478-5035
Second Address
- Jessica Pendergraft
- 615 Amy Dr
- Waukomis, OK
- Zip : 73773-1033
- Phone : (580) 478-5035
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TR0400X | Rehabilitation Psychologist |
National Provider Identifier
| NPI | 1659771996 |
|---|---|
| Provider Name | Jessica Pendergraft |
| First Address | Waukomis, OK 73773-1033 |
| Second Address | Waukomis, OK 73773-1033 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/08/2014 |
| Last Update Date | 22/08/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.