Provider Demographics
NPI:1760225833
Name:MENJA, EUNICE WAMUYU (LMFT-C)
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:WAMUYU
Last Name:MENJA
Suffix:
Gender:F
Credentials:LMFT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19452 CURRANT DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-3498
Mailing Address - Country:US
Mailing Address - Phone:405-408-8868
Mailing Address - Fax:
Practice Address - Street 1:9212 N KELLEY AVE STE 200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-2419
Practice Address - Country:US
Practice Address - Phone:405-242-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLMFTCANDIDATE12226106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist