Lara Jernigan

NPI #1114393436 in Chickasha, Oklahoma

Provider Information

NPI Number: 1114393436
Entity Type: Individual
Name: Lara Jernigan
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Enumeration Date: Aug 20, 2015
Last Updated: Aug 20, 2015

Practice Location

Address: 205 W CHICKASHA AVE
Address 2: SUITE 1
City: Chickasha
State: Oklahoma
ZIP Code: 73018-2690
Phone: (405) 222-3018

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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