Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 3950 | OK |
NPI | 1003075748 |
---|---|
Provider Name | Jana Jean Webb |
First Address | Ada, OK 74821 |
Second Address | Ada, OK 74820-7911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 06/06/2008 |