Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 103TR0400X | OK |
NPI | 1144666868 |
---|---|
Provider Name | Ms. Sheila D Jones |
First Address | Poteau, OK 74953 |
Second Address | Tishomingo, OK 73460-2351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2013 |
Last Update Date | 21/05/2013 |