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Kimberley Diane Jarvis
Peer Specialist in Prague, Oklahoma
NPI 1396496899

Kimberley Diane Jarvis is a Peer Specialist based in Prague, OK. Kimberley Diane Jarvis practices in Prague, OK. The NPI Number for Kimberley Diane Jarvis is 1396496899 and holds a License No. (Oklahoma).

The current practice location address for Kimberley Diane Jarvis is 11637 Ns 3580 Rd, Prague, OK and can be reached out via phone at 405-812-8898.

Location: 11637 Ns 3580 Rd, Prague, OK, 74864-6479
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396496899
Provider Name
Kimberley Diane Jarvis
Credential
Provider Entity Type
Individual
Gender
Female
Address
11637 Ns 3580 Rd, Prague, OK, 74864-6479
Phone Number
405-812-8898
Fax Number
Provider Enumeration Date
01/16/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
11131969 01 SELF
institution
Provider Business Practice Location Address Details
Address
11637 Ns 3580 Rd
City
Prague
State
Oklahoma
Zip
74864-6479
Phone Number
405-812-8898
Fax Number
person
Provider Business Mailing Address Details
Address
11637 Ns 3580 Rd
City
Prague
State
Oklahoma
Zip
74864-6479
Phone Number
405-812-8898
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Oklahoma)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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